A comparison of propofol and midazolam/meperidine sedation in upper gastrointestinal endoscopy.
BACKGROUND
There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE). Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE) are few.


OBJECTIVE
To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times.


METHODS
This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy. The patients were divided into propofol and midazolam/meperidine groups. Randomization was generated by a computer. Cardiopulmonary side effects (hypotension, bradycardia, hypoxemia), procedure-related times (endoscopy time, awake time, time to hospital discharge), and patient and endoscopist satisfaction were compared between groups.


RESULTS
There was no significant difference between the groups with respect to the cost, endoscopy time, or demographic and clinical characteristics of the patients. Awake time and time to hospital discharge were significantly shorter in the propofol group (6.58 ±4.72 vs. 9.32 ±4.26 min, p = 0.030 and 27.60 ±7.88 vs. 32.00 ±10.54 min, p = 0.019). Hypotension incidence was significantly higher in the propofol group (12% vs. 0%, p = 0.027). The patient and endoscopist satisfaction was better with propofol.


CONCLUSIONS
Propofol may be preferred to midazolam/meperidine sedation, with a shorter awake and hospital discharge time and better patient and endoscopist satisfaction. However, hypotension risk should be considered with propofol, and careful evaluation is needed, particularly in cardiopulmonary disorders.
Department of Anesthesiology and Reanimation, Haseki Training and Research Hospital, Istanbul, Turkey.
Sinan
S
Uzman
Department of General Surgery, Arnavutkoy State Hospital, Istanbul, Turkey.
Bunyamin
B
Gurbulak
Department of General Surgery, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Esin Kabul
EK
Gurbulak
Department of General Surgery Lutfiye Nuri Burat State Hospital, Istanbul, Turkey.
Turgut
T
Donmez
Department of General Surgery, Haseki Training and Research Hospital, Istanbul, Turkey.
Adnan
A
Hut
Department of General Surgery, Haseki Training and Research Hospital, Istanbul, Turkey.
Dogan
D
Yildirim
gastrointestinal endoscopy; meperidine; midazolam; moderate sedation; propofol