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 esophagogastroduodenoscop...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2015-04, Vol.18 (2), p.326-331
Main Authors: Yamamoto, Hisae, Gotoda, Takuji, Nakamura, Tetsuro, Yamamoto, Tetsuro, Kikuchi, Hitoshi, Kitamura, Masatsugu, Itoi, Takao, Moriyasu, Fuminori
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Anesthesia Recovery Period
Anesthetics, Intravenous - administration & dosage
Cancer Research
Endoscopy, Digestive System - methods
Female
Follow-Up Studies
Gastric cancer
Gastroenterology
Humans
Male
Medicine
Medicine & Public Health
Midazolam - administration & dosage
Middle Aged
Oncology
Original Article
Prognosis
Propofol - administration & dosage
Prospective Studies
Stomach Neoplasms - diagnosis
Surgical Oncology
Young Adult
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Summary: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  
ISSN:1436-3291
1436-3305
DOI:10.1007/s10120-014-0371-1