Clinical impact of gastroenterologist-administered propofol during esophagogastroduodenoscopy: a randomized comparison at a single medical clinic.
BACKGROUND
Although midazolam is widely used during endoscopic procedures by endoscopists, propofol has been recently favored for its rapid action and metabolism. The aim of this study is to compare the clinical advantages between propofol and midazolam use during screening esophagogastroduodenoscopy (EGD) for gastric cancer and post-procedure management at a medical clinic.


METHODS
One hundred six healthy patients aged 20-69 years requesting sedation for screening EGD from October 2012 to May 2013 at a single clinic in Japan were randomly assigned to propofol (n = 54) or midazolam (n = 52). Medications were given by bolus injection, and the dose was adjusted by body weight. Sedation level and tolerability during EGD and recovery time were assessed. Sedation level and tolerability were evaluated by American Society of Anesthesiologists responsiveness levels and four levels of the gag reflex, respectively. For safety purposes, endoscopists and nurses were trained in administering propofol and an anesthesiologist was on call at all times.


RESULTS
No statistically significant differences were found between the two groups in sedation level and patient tolerability. Full recovery time in the propofol group (4.7 min) was significantly shorter than that in the midazolam group (24 min, P < 0.01).


CONCLUSIONS
Regarding post-procedure management of patients in a medical clinic, propofol use might not necessitate a recovery room and excessive assessment tasks because of rapid recovery time without any prolonged reaction, which causes patient compliance. (


BACKGROUND
UMIN000009142.).
Department of Gastroenterology, Tokyo East Hospital, Tokyo, Japan.
Hisae
H
Yamamoto
Takuji
T
Gotoda
Tetsuro
T
Nakamura
Tetsuro
T
Yamamoto
Hitoshi
H
Kikuchi
Masatsugu
M
Kitamura
Takao
T
Itoi
Fuminori
F
Moriyasu
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D011379:Prognosis; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis*; D055815:Young Adult
D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol