Propofol versus Midazolam for Sedation during Esophagogastroduodenoscopy in Children

Background/Aims: To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children. Methods: We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from 34 consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures. Results: There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30 +/- 16.41 minutes) compared with midazolam group (58.89 +/- 17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04 +/- 19.92 and 97.82 +/- 16.7) compared with propofol group (110.26 +/- 20.14 and 83.26 +/- 12.33; p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures. Conclusions: Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.