[Comparative study of propofol and midazolam for sedation in regional anesthesia]

To compare the efficacy of propofol and midazolam as sedatives in non-premedicated patients receiving regional anesthesia.

Parameters measured were quality of sedation, intraoperative changes in hemodynamics, respiration and plasma biochemistry as compared with baseline, preinduction and post-anesthetic recovery levels. Forty patients were distributed randomly into two groups. Group P (n = 20) received an infusion of 1% propofol (10 mg/ml) at an initial rate of 6 mg/kg/h for 10 minutes, later decreased to 3 mg/kg/h. Group M (n = 20) received an infusion of 0.3% midazolam with an initial bolus of 0.06 mg/kg along with simultaneous infusion at a rate of 0.05 mg/kg/h.

Adequate sedation that was easily controlled during surgery was attained in both groups. The mean doses used were 336.7 +/- 33.7 mg in group P and 10.1 +/- 1.1 mg in group M. No significant changes in hemodynamic and respiratory parameters were observed. Differences between baseline and preinduction levels were found in some analyses, but significant changes during surgery were recorded only for HCO3-. There were no differences in recovery time from the moment infusion ceased until spontaneous eye opening and recall of date of birth. The degree of amnesia was greater in the midazolam group. The lesser amnesia with propofol meant that psychological measures were higher (p < 0.01). No differences in side effects were found.

Continuous perfusion of propofol and midazolam for sedation in regional anesthesia are equivalent with respect to efficacy and safety.