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Comparison between Midazolam Used Alone and in Combination with Propofol for Sedation during Endoscopic Retrograde Cholangiopancreatography.

Kim YS, Kim MH, Jeong SU, Lee BU, Lee SS, Park do H, Seo DW, Lee SK - Clin Endosc (2014)

Bottom Line: The recovery time was faster in the MP group than in the M group (p=0.031).Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046).There is no difference in the safety of the procedure.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Endoscopic retrograde cholangiopancreatography (ERCP) is an uncomfortable procedure that requires adequate sedation for its successful conduction. We investigated the efficacy and safety of the combined use of intravenous midazolam and propofol for sedation during ERCP.

Methods: A retrospective review of patient records from a single tertiary care hospital was performed. Ninety-four patients undergoing ERCP received one of the two medication regimens, which was administered by a nurse under the supervision of a gastroenterologist. Patients in the midazolam (M) group (n=44) received only intravenous midazolam, which was titrated to achieve deep sedation. Patients in the midazolam pulse propofol (MP) group (n=50) initially received an intravenous combination of midazolam and propofol, and then propofol was titrated to achieve deep sedation.

Results: The time to the initial sedation was shorter in the MP group than in the M group (1.13 minutes vs. 1.84 minutes, respectively; p<0.001). The recovery time was faster in the MP group than in the M group (p=0.031). There were no significant differences between the two groups with respect to frequency of adverse events, pain experienced by the patient, patient discomfort, degree of amnesia, and gag reflex. Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046).

Conclusions: The combined use of intravenous midazolam and propofol for sedation during ERCP is more effective than midazolam alone. There is no difference in the safety of the procedure.

No MeSH data available.


Related in: MedlinePlus

Degree of amnesia during endoscopic retrograde cholangiopancreatography under sedation. There is no statistical significance between the midazolam (M) group and the midazolam plus propofol (MP) group.
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Figure 2: Degree of amnesia during endoscopic retrograde cholangiopancreatography under sedation. There is no statistical significance between the midazolam (M) group and the midazolam plus propofol (MP) group.


Comparison between Midazolam Used Alone and in Combination with Propofol for Sedation during Endoscopic Retrograde Cholangiopancreatography.

Kim YS, Kim MH, Jeong SU, Lee BU, Lee SS, Park do H, Seo DW, Lee SK - Clin Endosc (2014)

Degree of amnesia during endoscopic retrograde cholangiopancreatography under sedation. There is no statistical significance between the midazolam (M) group and the midazolam plus propofol (MP) group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928499&req=5

Figure 2: Degree of amnesia during endoscopic retrograde cholangiopancreatography under sedation. There is no statistical significance between the midazolam (M) group and the midazolam plus propofol (MP) group.
Bottom Line: The recovery time was faster in the MP group than in the M group (p=0.031).Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046).There is no difference in the safety of the procedure.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Endoscopic retrograde cholangiopancreatography (ERCP) is an uncomfortable procedure that requires adequate sedation for its successful conduction. We investigated the efficacy and safety of the combined use of intravenous midazolam and propofol for sedation during ERCP.

Methods: A retrospective review of patient records from a single tertiary care hospital was performed. Ninety-four patients undergoing ERCP received one of the two medication regimens, which was administered by a nurse under the supervision of a gastroenterologist. Patients in the midazolam (M) group (n=44) received only intravenous midazolam, which was titrated to achieve deep sedation. Patients in the midazolam pulse propofol (MP) group (n=50) initially received an intravenous combination of midazolam and propofol, and then propofol was titrated to achieve deep sedation.

Results: The time to the initial sedation was shorter in the MP group than in the M group (1.13 minutes vs. 1.84 minutes, respectively; p<0.001). The recovery time was faster in the MP group than in the M group (p=0.031). There were no significant differences between the two groups with respect to frequency of adverse events, pain experienced by the patient, patient discomfort, degree of amnesia, and gag reflex. Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046).

Conclusions: The combined use of intravenous midazolam and propofol for sedation during ERCP is more effective than midazolam alone. There is no difference in the safety of the procedure.

No MeSH data available.


Related in: MedlinePlus