Key result
Propofol alone significantly reduced awakening time to 3.18 minutes compared to 15.7 minutes with propofol plus midazolam during ambulatory digestive endoscopic procedures.
Why the study?
The study aimed to evaluate which anesthetic drug combination most frequently used for ambulatory gastrointestinal endoscopic procedures best covers the needs of the patient and gastroenterologist.
Does propofol alone compared to propofol combined with midazolam improve awakening time and hemodynamic stability in patients undergoing ambulatory digestive endoscopy?
RCT (n=100)
Double-blind
Randomly allocated
No
Does propofol alone compared to propofol combined with midazolam improve awakening time and hemodynamic stability in patients undergoing ambulatory digestive endoscopy?
Absolute Event Rate: 3.18% vs 15.7%
p-value: p=<0.00001
Propofol alone provides faster anesthetic induction, quicker awakening, and better hemodynamic stability compared to a combination of propofol and midazolam for ambulatory digestive endoscopy.
Optimal sedation regimens for ambulatory colonoscopy remain unclear; leaves open best combination for patient and endoscopist needs.
Anesthesia is essential during colonoscopy because it provides patients with necessary sedation to perform the investigation safely and nonetheless to obtain the highest quality of the results. We aimed here to evaluate and establish which of the combinations of anesthetic drugs most frequently used for sedation purposes for gastrointestinal endoscopic procedures performed in the ambulatory best covers the needs of the patient and the gastroenterologist. This is a prospective, randomized, double-blind study carried out on a total of 100 patients, aged between 18 and 80 years, who meet the conditions for inclusion in the study. Patients were randomly allocated into either group A (Propofol) or group B (Midazolam plus Propofol). Evaluation of the dose of Propofol used in the 2 groups, awakening time, anesthetic induction, as well as the occurrence of episodes of bradycardia and hypotension represented the parameters followed in the study. In group A, 50 patients received on average 218.6mg of Propofol in bolus of 10-20mg. In group B, 50 patients received 0.1mg/kg Midazolam and an average of up to 129.2mg of Propofol in bolus of 10-20mg. Awakening time was shorter in group A-3.18 minutes, than in group B-15.7 minutes. Bradycardia and hypotension were met in a larger number in group B than in group A. The quality of the endoscopic evaluation was similar in both groups. The conclusion of our study was that the group to which only Propofol was administered had the best results from all aspects (rapid anesthetic induction, stability of vital functions, lower cost, awakening time much faster) compared to the combination of Propofol with Midazolam.
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Popa-Ion et al. (2022) conducted an RCT in Ambulatory Care Digestive Endoscopic Procedures (n=100). Propofol vs. Propofol combined with Midazolam (0.1 mg/kg Midazolam + 1 mg/kg Propofol) was evaluated on Awakening time (minutes) (p=<0.00001). Propofol alone significantly reduced awakening time to 3.18 minutes compared to 15.7 minutes with propofol plus midazolam during ambulatory digestive endoscopic procedures.
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