Comparison of the safety and efficacy of propofol with midazolam for sedation of patients with severe traumatic brain injury: A meta-analysis

• Published in: Journal of critical care 2014-04, Vol.29 (2), p.287-290
• Main Authors: Gu, Jian-wen, MD, PhD, Yang, Tao, MD, Kuang, Yong-qin, MD, PhD, Huang, Hai-dong, MD, Kong, Bin, MD, Shu, Hai-feng, MD, PhD, Yu, Si-xun, MD, PhD, Zhang, Jun-hai, MD
• Format: Article
• Language: English
• Subjects: Anesthesia; Brain damage; Brain Injuries - drug therapy; Brain Injuries - mortality; Cerebrovascular Circulation - drug effects; Clinical trials; Confidence intervals; Conscious Sedation - methods; Critical Care; Drug Monitoring - methods; Drug therapy; Female; Glasgow Outcome Scale; Humans; Hypertension; Hypnotics and Sedatives - adverse effects; Hypnotics and Sedatives - therapeutic use; Intracranial Pressure - drug effects; Meta-analysis; Midazolam; Midazolam - adverse effects; Midazolam - therapeutic use; Middle Aged; Mortality; Propofol; Propofol - adverse effects; Propofol - therapeutic use; Randomized Controlled Trials as Topic; Sedation; Standard deviation; Studies; Traumatic brain injury
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2013.10.021

Abstract Objective To perform a meta-analysis to compare the safety and efficacy of propofol with midazolam for sedation of patients with severe traumatic brain injury. Materials and Methods Studies were included in the meta-analysis if they met the following criteria: randomized controlled trial of sedative-hypnotic agents including propofol and midazolam; patients had severe traumatic brain injury; the primary outcome was the Glasgow Outcome Scale score; secondary outcomes included mortality, therapeutic failure, intracranial pressure, and cerebral perfusion pressure. The data were analyzed using software for meta-analysis. Results Seven relevant studies were identified. Three of these studies were excluded: one was a single-arm study, one compared morphine and propofol, and for one the full text article could not be obtained. The remaining 4 studies were included in the meta-analysis. The results of the meta-analysis showed that propofol and midazolam have similar effects on the Glasgow Outcome Scale score, mortality, intracranial pressure, and cerebral perfusion pressure. Conclusion Our meta-analysis of 4 studies showed that there are no important differences between propofol and midazolam when administered to provide sedation for patients with severe traumatic brain injury. Further randomized, controlled trials comparing propofol with midazolam for sedation of such patients are needed.