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.