title: Propofol-alfentanyl versus midazolam-alfentanyl in inducing procedural amnesia of upper gastrointestinal endoscopy in children--blind randomised trial.
abstract: In paediatric patients, esophagogastroduodenoscopy (EGD) is commonly performed with the use of sedation. The aim of the study was to compare the effectiveness of propofol and midazolam in providing procedural amnesia and controlling behaviour in children undergoing diagnostic EGD. Children (9-16 years), classified to the first or second class of the American Society of Anaesthesiologists' physical status classification referred for EGD, were randomly assigned to receive propofol with alfentanyl or midazolam with alfentanyl for sedation during the procedure. Within 120 min after the procedure, patients were repeatedly investigated for memory of the procedure and for memory of pain intensity during EGD with the use of the visual analogue scale. Activity and cooperation of the patient during the procedure was assessed with the relative adequacy scale. Of the 51 children, 48 completed the study. Propofol was significantly better than midazolam in inducing amnesia of procedural pain (mean difference 11.53 mm; 95 % confidence interval [CI] 0.96 to 22.10), loss of memory of the procedure (relative risk 0.4; 95 % CI 0.21 to 0.59) and controlling behaviour (relative risk 2.12; 95 % CI 1.33 to 3.36).
  
  
  CONCLUSIONS
  In children sedated for EGD, propofol is significantly better than midazolam at providing procedural amnesia and controlling behaviour during the procedure.
authors.affiliation: Department of Paediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Dzialdowska 1, 01-184, Warsaw, Poland. edi.sienkiewicz@gmail.com.
authors.forename: Edyta
authors.initials: E
authors.lastname: Sienkiewicz
authors.affiliation: Department of Paediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Dzialdowska 1, 01-184, Warsaw, Poland. dr.piotr.albrecht@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Albrecht
authors.affiliation: Department of Paediatric Anesthesiology and Intensive Therapy, The Medical University of Warsaw, Dzialdowska 1, 01-184, Warsaw, Poland. janusz.j.ziolkowski@gmail.com.
authors.forename: Janusz
authors.initials: J
authors.lastname: Ziółkowski
authors.affiliation: Department of Paediatrics, The Medical University of Warsaw, Dzialdowska 1, 01-184, Warsaw, Poland. piotrdz@hotmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Dziechciarz
mesh_terms: D000293:Adolescent; D015760:Alfentanil / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D016292:Procedural Sedation / Q000379:methods; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008568:Memory / Q000187:drug effects; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D008874:Midazolam; D015742:Propofol
keywords: Children; Deep sedation; Endoscopy; General anaesthesia; Pain