A meta-analysis found lower midazolam doses in older patients undergoing endobronchial ultrasound-guided sampling, with broadly comparable procedural outcomes.
The review combined six studies involving 5,206 participants. Older age was defined using thresholds of either 65 or 70 years, depending on the study. Overall diagnostic yield and procedure duration were similar between older and younger groups. The pooled overall complication risk ratio was 0.95, with a confidence interval from 0.74 to 1.23.
Older participants received an average of 1.11 mg less midazolam. That difference documents how sedation was delivered within the included studies; it is not a universal age-based dose adjustment.
Comparable complication rates do not establish that the same sedation exposure would be equally tolerated at every age. Clinicians may have selected patients, adjusted medication, or changed monitoring and support. The lower dose is part of the context in which outcomes were observed.
The small number of studies and heterogeneity in diagnostic yield limit generalization. For a case review, examine the actual procedural technique, baseline condition, co-medication, and individualized titration. This paper supports describing successful sampling in studied older groups, while avoiding a claim that age has no relevance to benzodiazepine response.
Original analysis of the supplied journal article, identified as PMC12933988.