Related Experiment Videos
[Propofol for sedation in gastroscopy--a randomized comparison with midazolam]
C Hofmann1, R Kiesslich, A Brackertz
1Innere Abteilung, St.-Hildegardis-Krankenhaus Mainz.
Unlabelled:
Midazolam, a benzodiazepine with amnestic and sedative effects is the drug of choice for sedation of patients undergoing upper gastrointestinal endoscopy. Propofol, a phenolic derivate, is a short-acting anesthetic producing a more rapid onset sedation amnesia and a shorter recovery than midazolam: In higher doses it acts as hypnotic. The aim of this study was to evaluate both drugs in a prospective randomized trial for sedation of patients undergoing esophagogastroduodenoscopy (EGD).
Methods:
60 patients undergoing EGD were randomized to receive either propofol (n = 30) or midazolam (n = 30). No other analgetic or sedative drugs were used. 3 l oxygen were given routinely by nose. Blood pressure, oxygen saturation (pulse oxymetry) and heart rate was monitored continuously. The sedation quality was determined from the endoscopist and patient separately by use of a scale as either good, fair or insufficient.
Results:
Changes of the heart rate and oxygen saturation showed no differences in both groups (> 0.05). The blood pressure decreased significant by using propofol (p < 0.01). The sedation quality was good in both groups without significant differences. The recovery time was shorter if propofol was administered (p < 0.01).
Conclusions:
Propofol is an alternative drug for sedation in upper endoscopy. It showed same sedation quality as midazolam with the advantage of a short recovery time. Because of a possible decrease of the blood pressure continuous monitoring is recommended.
Insights
Propofol offers comparable sedation quality to midazolam for upper endoscopy, with a significantly faster recovery time. Continuous monitoring is advised due to potential blood pressure decreases with propofol.
Area of Science:
- Gastroenterology
- Anesthesiology
- Pharmacology
Background:
- Midazolam is a common choice for sedation during upper gastrointestinal endoscopy due to its amnestic and sedative properties.
- Propofol, a short-acting anesthetic, offers rapid onset sedation and amnesia, with potential hypnotic effects at higher doses.
Purpose of the Study:
- To compare the efficacy and safety of propofol versus midazolam for sedation during esophagogastroduodenoscopy (EGD) in a prospective randomized trial.
Main Methods:
- Sixty patients undergoing EGD were randomized to receive either propofol (n=30) or midazolam (n=30).
- Vital signs including blood pressure, oxygen saturation, and heart rate were continuously monitored.
- Sedation quality was assessed by both the endoscopist and the patient.
Main Results:
- No significant differences were observed in heart rate or oxygen saturation between the propofol and midazolam groups.
- Propofol administration resulted in a significant decrease in blood pressure (p < 0.01).
- Sedation quality was rated as good in both groups, with a significantly shorter recovery time for propofol (p < 0.01).
Conclusions:
- Propofol serves as a viable alternative for sedation in upper endoscopy, providing equivalent sedation quality to midazolam.
- The primary advantage of propofol is its significantly shorter recovery time post-procedure.
- Continuous patient monitoring is recommended when using propofol due to the risk of blood pressure reduction.