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Conscious sedation for interventional neuroradiology: a comparison of midazolam and propofol infusion
P H Manninen1, A S Chan, D Papworth
1Department of Anaesthesia, Toronto Hospital, University of Toronto, Ontario, Canada.
Purpose:
The aim of this study was to compare two conscious sedation techniques, midazolam (M) and propofol (P), for interventional neuroradiology by assessment of the incidence of complications and satisfaction scores.
Methods:
Forty patients were randomized to receive 0.75 micrograms.kg-1 fentanyl and a M or P bolus followed by an infusion (M 15 micrograms.kg-1 + 0.5 micrograms.kg-1.min-1; P 0.5 mg.kg-1 + 25 micrograms.kg-1 min-1). The incidences of complications and untoward events requiring intervention were documented. These included respiratory depression, excessive pain, inappropriate movements and the inability to examine the patient. The satisfaction of the anaesthetic technique from the perspective of both the neuroradiologist and the patient was scored.
Results:
The incidence and types of complications were no different between the two groups. Pain occurred in 12 patients (6M, 6P), inappropriate movements in 17 (7M, 10P) and respiratory changes in 10 patients (2M, 8P).
Conclusions:
Both techniques were satisfactory and the incidence of complications was similar for both groups.
Insights
Midazolam and propofol provide comparable sedation for interventional neuroradiology, with similar complication rates and patient satisfaction. Both conscious sedation techniques are effective for these procedures.
Area of Science:
- Interventional Neuroradiology
- Anesthesiology
- Sedation Techniques
Background:
- Conscious sedation is crucial for interventional neuroradiology procedures.
- Midazolam and propofol are commonly used agents, but direct comparisons in this setting are valuable.
Purpose of the Study:
- To compare the efficacy and safety of midazolam versus propofol for conscious sedation during interventional neuroradiology.
- To assess complication incidence and patient/clinician satisfaction scores for each sedation method.
Main Methods:
- Forty patients undergoing interventional neuroradiology were randomized to receive fentanyl plus either midazolam or propofol.
- Sedation involved a bolus followed by an infusion, with specific dosages detailed for each agent.
- Complications (respiratory depression, pain, movement) and satisfaction were systematically documented.
Main Results:
- No significant differences in the overall incidence or types of complications were observed between the midazolam and propofol groups.
- Specific complications included pain (12 patients), inappropriate movements (17 patients), and respiratory changes (10 patients), distributed across both groups.
- Satisfaction scores were similar for both anesthetic techniques.
Conclusions:
- Both midazolam and propofol are satisfactory conscious sedation techniques for interventional neuroradiology.
- The incidence of complications is comparable between midazolam and propofol in this patient population.