Effect of the midazolam added with propofol-based sedation in esophagogastroduodenoscopy: A randomized trial

Background and AimAlthough propofol has been widely used for sedation during esophagogastroduodenoscopy (EGD), adverse events including hypoxia and hypotension may be a concern in the propofol-based sedation. We aimed to analyze whether administration of midazolam would improve safety and efficacy of propofol-based sedation in EGD. MethodsOne hundred twenty patients who were scheduled to undergo diagnostic EGD were randomly assigned to either midazolam plus propofol (MP) or propofol alone groups. In the MP group, 2mg of midazolam and 10mg of propofol were given initially. In the propofol alone group, 40-60mg of propofol was given initially. In both groups, 20mg of propofol was given repeatedly to maintain moderate sedation as needed. Vital signs including oxygen saturation were monitored every 2min. After the patients fully recovered, satisfaction score was investigated from endoscopists, nurses, and patients, respectively. ResultsThe baseline characteristics did not differ between the MP and propofol alone groups. The mean required doses of propofol was (meanstandard deviation) 0.3 +/- 0.3 and 0.8 +/- 0.2mg/kg in the MP and propofol alone groups, respectively (P<0.001). In addition, sedation-related adverse events and recovery time did not differ between the two groups. The proportion of satisfactory did not differ between the two groups (MP vs propofol alone; proportion; patient, 95.0% vs 93.3%, P>0.999; endoscopist, 73.3% vs 80.0%, P=0.064; nurse, 73.3% vs 76.7%, P=0.551). ConclusionAdding midazolam to propofol did not reduced the safety and efficacy, and sedation using propofol alone could be suitable for sedation during diagnostic EGD.