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Endoscopy. 1995 Mar;27(3):240-3.

Sedation for upper gastrointestinal endoscopy: a comparative study of propofol and midazolam.

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1
Department of Surgery, General Hospital, Oskarshamn, Sweden.

Abstract

BACKGROUND AND STUDY AIMS:

A benzodiazepine is generally used when sedation is required for endoscopy, whilst the newer agent propofol appears to have a more suitable pharmacokinetic profile. The aim of this study was to compare the quality of sedation provided by midazolam and propofol under controlled conditions.

PATIENTS AND METHODS:

Ninety healthy outpatients requesting sedation at diagnostic gastroscopy were prospectively randomized to receive a bolus dose of either midazolam 0.06 mg/kg or propofol 0.6 mg/kg, followed by repeat doses of 50% of the initial dose as required. No topical anesthesia was used. The endoscopist and the patient replied to a questionnaire.

RESULTS:

Patients receiving propofol tolerated endoscopy better (p = 0.01); reached a deeper maximum level of sedation (p = 0.001); and recovered more rapidly (p = 0.001). There was a similar frequency of amnesia for the procedure (propofol 67% vs. midazolam 65%); of oxygen desaturation (four patients in each group, < 85%); and of perceived patient comfort (p = 0.5).

CONCLUSIONS:

Compared to midazolam, propofol facilitated gastroscopy to a greater extent. However, due to its narrower therapeutic range, propofol is the more demanding agent to administer, thus making it less universally applicable than midazolam.

PMID:
7664702
DOI:
10.1055/s-2007-1005678
[Indexed for MEDLINE]

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