Wednesday, September 16, 2009

Germans more humane than US Doctors!!!

This abstract is taken from an on line report which can be viewed here...FHA - Midazolam-pain, but one cannot remember it: a survey among Southern German endoscopists - Article Summary A fellow sufferer sent me this, thanks!


BACKGROUND: Benzodiazipines, especially Midazolam, are the most frequently used agents for gastrointestinal endoscopy worldwide. Among the parameters the quality of sedation is determined by patients' satisfaction assessed after endoscopy. This approach is misleading as the potent amnestic effect of Midazolam conceals pain actually suffered during the endoscopic procedure involving distraction of the endoscopists (poor babies) from their actual tasks by audible reactions and defense movements. In this study, we eliminated the influence of patients' amnesia on the assessment of the quality of sedation and rather interviewed endoscopists and their assistant personnel about their experience with Midazolam sedation. We replaced the mostly vague term 'compliance' (compliance, here we have the number one reason for Midazolam use) by terms which unequivocally describe the reactions of the patient during unpleasant endoscopy. METHODS: A short survey consisting of 12 questions was developed. The questionaires were distributed to the participants - 115 endoscopists and their assistants - of a tutorial about sedation for gastrointestinal endoscopy in three major Southern German cities. The questionaire retrieved the endoscopists' experience regarding the patients' discomfort or pain under sedation with Midazolam, their wish for better sedative agents, their preferred sedative regimens, their medical specialty and their professional experience. RESULTS: Participants were highly experienced with the majority having more than 10,000 procedures and a median of 18 years of endoscopic experience; 77% of endoscopists utilized Midazolam for sedation. 98% ( that's almost every single on of these doctors!) of the questioned physicians felt that the patients have pain during endoscopy with Midazolam +/- opiod but do not remember later. 92% reported that it happens that patients moan aloud because of pain and almost half (48%) reported of screaming. (read that again! Half of the doctors report patients actually screaming in pain) The majority of endoscopists (91%) reported fierce defensive movements (this is almost unbelievable that Doctors in Germany are truthful enough to report this! What happened to this "wonderful drug" that everybody just loves?) with Midazolam or the need to hold the patient down on the examination couch because of fierce movements, respectively 75%. (75% of doctors are holding the patient down so that they can continue to torture them.) 70% of the endoscopists wished to have the rooms for endoscopy preferably soundproof away from the waiting room and 93% wished for better sedative agents. (Here we have the meat of the story. Versed is sooo bad that they wish for a soundproof room well away from other people. A TORTURE CHAMBER ANYBODY? How can anybody justify this inhumane treatment and glibly say that Midazolam is a good drug when they have WITNESSED people enduring this kind of pain?) Conclusion: Midazolam was rated as insufficient for sedation by both endoscopists and their assistant personnel. A wish for better sedation drugs exists. (I shudder to think what 'better sedation drugs' means. In another post we see that a medical person wishes not to have people scream in his ear, so he wants to sedate people. Here we have members of the most trusted profession out there talking about being irritated that these patients are screaming and trying to escape. They want torture chambers so that nobody knows what they are doing. Nobody is talking about pain relief are they?)

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