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Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective,
H Seifert1, T H Schmitt, T Gültekin
1Department of Internal Medicine II, J.W. Goethe-University Hospital, Frankfurt am Main, Germany.
Alimentary Pharmacology & Therapeutics
|September 6, 2000
Summary
Propofol alone is as effective for endoscopic sedation as propofol with midazolam. While the combination uses less propofol, it leads to slower patient recovery.
Area of Science:
- Anesthesiology
- Gastroenterology
Background:
- Sedation is crucial for interventional endoscopic procedures.
- Propofol and midazolam may offer synergistic benefits for sedation efficacy, recovery, and cost-effectiveness due to potentially lower propofol requirements.
Purpose of the Study:
- To compare the efficacy and recovery profiles of propofol alone versus propofol plus midazolam for sedation during therapeutic endoscopy.
Main Methods:
- 239 patients undergoing EGD or ERCP were randomized to receive either propofol alone or propofol with midazolam.
- Continuous monitoring of vital signs was performed.
- Procedure parameters, recovery time, and quality (post-anesthesia recovery score) were assessed.
Main Results:
- Both sedation regimens demonstrated similar efficacy.
- The propofol-only group required a higher mean propofol dose (0.25 mg.min/kg vs. 0.20 mg.min/kg).
- Patients receiving propofol alone had significantly shorter recovery times (19 min vs. 25 min) and better recovery scores.
Conclusions:
- Sedation with propofol and midazolam during therapeutic endoscopy reduces the total propofol dose but does not improve sedation efficacy.
- This combination is associated with slower post-procedure recovery compared to propofol alone.