Propofol versus midazolam for sedation during percutaneous transluminal angioplasty.
OBJECTIVE
To prospectively and randomly compare use of propofol versus midazolam for sedation during percutaneous transluminal angioplasty (PTA).


METHODS
Forty patients (27 men, 13 women; mean age 64.4 years +/- 12.2) who underwent PTA of the arteries below the diaphragm were prospectively randomized for sedation with propofol or midazolam. Both drugs were administered after an initial bolus injection by means of continuous infusion to achieve conscious sedation at levels II-III according to the Ramsay classification. Patients and interventionalists were blinded to the applied sedative. Both groups were similar with regard to American Society of Anesthesiology status, heart rate, blood pressure, arterial oxygen pressure (pO2), arterial carbon dioxide pressure (pCO2), arterial oxygen saturation (SpO2), and visual analogue scores for general condition, anxiety, and pain. During PTA, heart rate, blood pressure, and pulse oximetry (tpO2) were monitored continually. Every 30 minutes, an arterial blood gas analysis was performed. Visual analogue scores were obtained before, during, and after intervention.


RESULTS
Decreases in SpO2, pO2, and tpO2 were significantly greater after sedation with midazolam (P < .05; t test). The increase in pCO2 was significantly greater after midazolam (P < .05; t test). No significant difference between the drugs was found with regard to any of the other parameters. Both drugs resulted in sufficient sedation and anxiolysis (P < .01 for both drugs for visual analogue score for anxiety before and during PTA; matched pairs test). Satisfaction of the interventionalist was significantly greater for propofol (P < .05; t test).


CONCLUSIONS
Propofol causes less respiratory depression than midazolam for equivalent sedation and anxiolysis in patients undergoing PTA.
Wagner
H J
HJ
Department of Diagnostic Radiology, University Hospital, Philipps University, Marburg, Germany.
Nowacki
J
J
Klose
K J
KJ
D000800:Angioplasty, Balloon; D001007:Anxiety / Q000503:physiopathology / Q000517:prevention & control; D001291:Attitude of Health Personnel; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D016292:Procedural Sedation / Q000145:classification; D005260:Female; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control; D010313:Partial Pressure; D016491:Peripheral Vascular Diseases / Q000628:therapy; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D015642:Radiology, Interventional; D016037:Single-Blind Method
D006993:Hypnotics and Sedatives; D002245:Carbon Dioxide; D008874:Midazolam; D010100:Oxygen; D015742:Propofol