Continued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.

Background And Aims: Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients.

Methods: Patients undergoing elective colonoscopy with moderate sedation were eligible.