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Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy.
Am J Gastroenterol. 2000 Jun; 95(6):1476-9.AJ

Abstract

OBJECTIVE

Propofol (2,6-diisopropyl phenol) is a relatively new intravenous sedative hypnotic with an ideal pharmacokinetic profile for conscious sedation. In this study, we compared the safety and efficacy of propofol versus the conventional regimen of midazolam and meperidine for conscious sedation in GI endoscopy.

METHODS

In this prospective study, 274 patients that included many elderly patients with multiple comorbid conditions underwent GI endoscopic procedures at our hospital. A total of 150 patients received propofol (20-120 mg) and fentanyl (0.25-1.5 mg). The control group of 124 patients was given midazolam (2-6 mg) and meperidine (25-75 mg). The dose of medication was titrated according to patient need and the duration of the procedure. A "comfort score" on a scale of 1-4 assessed the efficacy of the drugs based on pain or discomfort to the patient and ease of endoscopy. A "sedation score" was used to assess the degree of sedation on a scale of 1-5. The Aldrete score was used to measure recovery from anesthesia at 5 and 10 min after the procedure.

RESULTS

After controlling for age, American Society of Anesthesiologists' Physical Status Classification (ASA grade), and type and duration of procedure, logistic regression analysis determined that propofol resulted in 2.04 times better patient comfort (p = 0.033, 95% CI = 1.058-3.923). Propofol was 1.84 times more likely to produce deeper sedation than the regimen of midazolam and meperidine (p = 0.027, 95% CI = 1.071-3.083). The recovery from sedation was faster in patients receiving propofol, although this did not reach statistical significance. The safety parameters between the two groups were comparable.

CONCLUSION

Propofol was associated with a statistically significant improvement in comfort and sedation score when compared to midazolam and meperidine.

Authors+Show Affiliations

Division of Gastroenterology, Our Lady of Mercy Medical Center, New York Medical College, Bronx 10466, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

10894582

Citation

Koshy, G, et al. "Propofol Versus Midazolam and Meperidine for Conscious Sedation in GI Endoscopy." The American Journal of Gastroenterology, vol. 95, no. 6, 2000, pp. 1476-9.
Koshy G, Nair S, Norkus EP, et al. Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy. Am J Gastroenterol. 2000;95(6):1476-9.
Koshy, G., Nair, S., Norkus, E. P., Hertan, H. I., & Pitchumoni, C. S. (2000). Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy. The American Journal of Gastroenterology, 95(6), 1476-9.
Koshy G, et al. Propofol Versus Midazolam and Meperidine for Conscious Sedation in GI Endoscopy. Am J Gastroenterol. 2000;95(6):1476-9. PubMed PMID: 10894582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy. AU - Koshy,G, AU - Nair,S, AU - Norkus,E P, AU - Hertan,H I, AU - Pitchumoni,C S, PY - 2000/7/14/pubmed PY - 2000/8/1/medline PY - 2000/7/14/entrez SP - 1476 EP - 9 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 95 IS - 6 N2 - OBJECTIVE: Propofol (2,6-diisopropyl phenol) is a relatively new intravenous sedative hypnotic with an ideal pharmacokinetic profile for conscious sedation. In this study, we compared the safety and efficacy of propofol versus the conventional regimen of midazolam and meperidine for conscious sedation in GI endoscopy. METHODS: In this prospective study, 274 patients that included many elderly patients with multiple comorbid conditions underwent GI endoscopic procedures at our hospital. A total of 150 patients received propofol (20-120 mg) and fentanyl (0.25-1.5 mg). The control group of 124 patients was given midazolam (2-6 mg) and meperidine (25-75 mg). The dose of medication was titrated according to patient need and the duration of the procedure. A "comfort score" on a scale of 1-4 assessed the efficacy of the drugs based on pain or discomfort to the patient and ease of endoscopy. A "sedation score" was used to assess the degree of sedation on a scale of 1-5. The Aldrete score was used to measure recovery from anesthesia at 5 and 10 min after the procedure. RESULTS: After controlling for age, American Society of Anesthesiologists' Physical Status Classification (ASA grade), and type and duration of procedure, logistic regression analysis determined that propofol resulted in 2.04 times better patient comfort (p = 0.033, 95% CI = 1.058-3.923). Propofol was 1.84 times more likely to produce deeper sedation than the regimen of midazolam and meperidine (p = 0.027, 95% CI = 1.071-3.083). The recovery from sedation was faster in patients receiving propofol, although this did not reach statistical significance. The safety parameters between the two groups were comparable. CONCLUSION: Propofol was associated with a statistically significant improvement in comfort and sedation score when compared to midazolam and meperidine. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10894582/Propofol_versus_midazolam_and_meperidine_for_conscious_sedation_in_GI_endoscopy_ L2 - https://Insights.ovid.com/pubmed?pmid=10894582 DB - PRIME DP - Unbound Medicine ER -