Observational Study
Copyright ©The Author(s) 2021.
World J Clin Cases. Oct 16, 2021; 9(29): 8763-8772
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8763
Table 1 Baseline characteristics of enrolled participants (n = 361)

Non-recurrent group (n = 250), n (%)
Recurrent group (n = 111), n (%)
P value
Age (mean ± SD)49.57 ± 9.2251.15 ± 9.670.1395
Sex, male165 (66)67 (60.36)0.3022
BMI (kg/m2) (mean ± SD)23.74 ± 3.324.3 ± 3.690.1552
Smoking0.8010
Never 82 (40.39)33 (37.93)
Ex-smoker68 (33.5)28 (32.18)
Current smoker53 (26.11)26 (29.89)
Alcohol consumption0.9465
None to minimal (< 70 g/wk)120 (51.28)51 (52.58)
Moderate (70-279 g/wk) 82 (35.04)34 (35.05)
Heavy (> 280 g/wk) 32 (13.68)12 (12.37)
Medication18 (3.4)3 (3.09)1.000
HTN (Yes)54 (21.6)30 (27.03)0.2601
DM (Yes)19 (7.6)6 (5.41)0.4485
Hyperlipidemia56 (22.4)29 (26.13)0.4413
Table 2 Univariable analysis of procedure-related factors for recurrent paradoxical reactions

Non-recurrent group (n = 250)
Recurrent group (n = 111)
P value
Endoscope type, n (%)0.0765
H260157 (62.8)59 (53.64)
H29090 (36)51 (46.36)
Endoscopist experience, n (%)0.4251
Less experienced75 (30)41 (36.94)
Expert106 (42.4)43 (38.74)
Highly expert69 (27.6)27 (24.32)
Midazolam dose (mean ± SD)
Initial (mg)3.98 ± 14.19 ± 1.160.1804
Initial (mg/kg)0.06 ± 0.020.06 ± 0.020.4070
Total (mg)5.49 ± 2.046.74 ± 2.58< 0.0001
Total (mg/kg)0.08 ± 0.040.1 ± 0.04< 0.0001
Midazolam dose administered in previous endoscopy1 (mean ± SD)
Initial (mg)3.78 ± 0.953.84 ± 1.040.7277
Initial (mg/kg)0.06 ± 0.020.06 ± 0.020.8448
Total (mg)7.43 ± 2.797.4 ± 2.370.6087
Total (mg/kg)0.11 ± 0.050.11 ± 0.040.4360
Δ Midazolam dose difference (total) (mg)
Median value (quartile 25%, 75%)-2 (-3, 0)-1 (-2, 1)< 0.0001
Table 3 Multivariable analysis of risk factors for recurrent paradoxical reactions in 350 participants

OR
95%CI
P value1
Age1.0050.9781.0340.7025
Female gender (vs male)1.5210.7313.1640.262
BMI 1.0720.9921.1580.0797
Smoking
Ex-smoker (vs never smoker)1.070.4842.3660.8673
Current smoker (vs never smoker)1.3110.5723.0070.522
Alcohol
Moderate (vs none to minimal) 1.2830.6832.4090.438
Heavy (vs none to minimal) 0.9250.4132.0750.8504
Medication2: Yes (vs no)1.0550.2424.5980.9436
Endoscope type: H260 (vs H290)1.4050.8542.3120.1808
Endoscopist experience
Expert (vs less experienced)0.7120.4031.2560.2407
Highly expert (vs less experienced)0.8220.4341.5570.5477
Δ Midazolam dose difference (total) (mg) 1.2131.0991.3380.0001