Propofol versus midazolam plus meperidine for sedation during ambulatory esophagogastroduodenoscopy.
OBJECTIVE
To evaluate the efficacy and safety of propofol and meperidine plus midazolam for sedation during esophagogastroduodenoscopy (EGD) in children.


METHODS
Data were collected prospectively and retrospectively from neurologically intact children (0.2-17.7 years of age) who underwent ambulatory diagnostic EGD during a 4-year period. Data were included from 155 consecutive patients receiving propofol with or without premedication with midazolam (PM group). One hundred five consecutive patients who received sedation with a midazolam plus meperidine combination served as a comparison (MM group). Outcome variables were: time required for induction of sedation, length of procedure, time for recovery, need for additional supportive measures, and need for physical restraint.


RESULTS
The onset of sedation was faster and the length of procedure and recovery were significantly shorter in the PM group as compared with the MM group (P < 0.01). Patients in the MM group required restraint more often than in the PM group. A higher dose of meperidine and midazolam was used in the prospective study. This led to deeper sedation but increased need for additional support.


CONCLUSIONS
Propofol is safe and effective for facilitating EGD in children.
Khoshoo
Vikram
V
West Jefferson Medical Center, New Orleans, Louisiana, USA. vkhoshoo@earthlink.net
Thoppil
Dipu
D
Landry
Lisa
L
Brown
Shannan
S
Ross
Gerald
G
D000293:Adolescent; D019162:Anesthetics, Combined / Q000493:pharmacokinetics / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000493:pharmacokinetics / Q000494:pharmacology*; D007223:Infant; D008297:Male; D008614:Meperidine / Q000493:pharmacokinetics / Q000494:pharmacology; D008874:Midazolam / Q000493:pharmacokinetics / Q000494:pharmacology; D009294:Narcotics / Q000493:pharmacokinetics / Q000494:pharmacology*; D015742:Propofol / Q000493:pharmacokinetics / Q000494:pharmacology; D011446:Prospective Studies; D012149:Restraint, Physical; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome
D019162:Anesthetics, Combined; D006993:Hypnotics and Sedatives; D009294:Narcotics; D008614:Meperidine; D008874:Midazolam; D015742:Propofol