title: Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: a randomized trial.
abstract: OBJECTIVE
  To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy (iCLE) and sedation efficacy of propofol vs midazolam plus fentanyl (M/F).
  
  
  METHODS
  Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group (P group) or M/F group. The patient, performing endoscopist and endoscopic assistant were blinded to the randomization. The quality of endomicroscopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.
  
  
  RESULTS
  There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group (72.75% vs 52.89%, P < 0.001). The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group, although this did not reach statistical significance. Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F. Procedure duration and sedation times were significantly longer in the M/F group, while the scores of endoscopist, anesthetist and assistant assessment were all significantly better in the P group.
  
  
  CONCLUSIONS
  Sedation with propofol might increase the proportion of good quality endomicroscopic images, and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Xiu-Li
authors.initials: XL
authors.lastname: Zuo
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Liu
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Li
authors.forename: Rui
authors.initials: R
authors.lastname: Ji
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Cheng-Jun
authors.initials: CJ
authors.lastname: Zhou
authors.forename: Han
authors.initials: H
authors.lastname: Liu
authors.forename: Yan-Qing
authors.initials: YQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D016292:Procedural Sedation / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D015742:Propofol / Q000494:pharmacology*; D041742:Upper Gastrointestinal Tract
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol