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Randomized controlled trial for endoscopy with propofol versus midazolam on psychometric tests and critical flicker frequency in people with cirrhosis.
J Gastroenterol Hepatol. 2012 Nov; 27(11):1726-32.JG

Abstract

BACKGROUND AND AIM

People with cirrhosis are at increased risk of development of complications related to sedation. The aim of the present study was to compare the effects of sedation for upper gastrointestinal endoscopy (UGIE) with propofol and midazolam on psychometric tests and critical flicker frequency (CFF) in people with cirrhosis.

METHODS

A total of 127 people with cirrhosis were randomized into three groups: propofol group (n = 40), midazolam group (n = 42) and no sedation (n = 45). All patients underwent CFF test and combination of psychometry (number connection test-A and B [NCT-A,B]; digit symbol test [DST], line tracing test [LTT] and serial dotting test [SDT]) at baseline and at 2 h post-endoscopy. CFF was done at 30 min and repeated every 30 min for 2 h.

RESULTS

In the propofol group there was no deterioration in psychometry (NCT-A [55.6 ± 18.7 vs 56.4 ± 19.0 s], NCT-B [98.2 ± 35.1 vs 97.8 ± 34.6 s], DST [26.7 ± 5.7 vs 26.3 ± 5.3], LTT [112.9 ± 35.7 vs 113.7 ± 36.6 s], SDT [94.6 ± 34.1 vs 95.2 ± 34.5 s]). Significant deterioration from baseline (39.8 ± 2.9 Hz) was seen in CFF at 30 min (38.8 ± 2.3 Hz) and 1 h (39.2 ± 2.4 Hz), P = 0.01 but no difference thereafter. In the midazolam group, significant deterioration was observed on psychometry (NCT-A [56.0 ± 18.5 vs 60.4 ± 19.8 s], NCT-B [99.9 ± 29.1 vs 105.9.6 ± 30.3 s], DST [26.1 ± 4.7 vs 25.2 ± 4.3], LTT [129.1 ± 34.5 vs 132.9 ± 35.4 s], SDT [95.6 ± 34.2]). No deterioration was observed in psychometry and CFF in people with cirrhosis without sedation.

CONCLUSIONS

Propofol sedation for UGIE was associated with earlier recovery compared with midazolam, which causes deterioration of psychometric tests and CFF for a longer time in comparison with propofol.

Authors+Show Affiliations

Department of Gastroenterology, GB Pant Hospital, New Delhi, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22861074

Citation

Agrawal, Amit, et al. "Randomized Controlled Trial for Endoscopy With Propofol Versus Midazolam On Psychometric Tests and Critical Flicker Frequency in People With Cirrhosis." Journal of Gastroenterology and Hepatology, vol. 27, no. 11, 2012, pp. 1726-32.
Agrawal A, Sharma BC, Sharma P, et al. Randomized controlled trial for endoscopy with propofol versus midazolam on psychometric tests and critical flicker frequency in people with cirrhosis. J Gastroenterol Hepatol. 2012;27(11):1726-32.
Agrawal, A., Sharma, B. C., Sharma, P., Uppal, R., & Sarin, S. K. (2012). Randomized controlled trial for endoscopy with propofol versus midazolam on psychometric tests and critical flicker frequency in people with cirrhosis. Journal of Gastroenterology and Hepatology, 27(11), 1726-32. https://doi.org/10.1111/j.1440-1746.2012.07231.x
Agrawal A, et al. Randomized Controlled Trial for Endoscopy With Propofol Versus Midazolam On Psychometric Tests and Critical Flicker Frequency in People With Cirrhosis. J Gastroenterol Hepatol. 2012;27(11):1726-32. PubMed PMID: 22861074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized controlled trial for endoscopy with propofol versus midazolam on psychometric tests and critical flicker frequency in people with cirrhosis. AU - Agrawal,Amit, AU - Sharma,Barjesh Chander, AU - Sharma,Praveen, AU - Uppal,Rajiv, AU - Sarin,Shiv Kumar, PY - 2012/8/7/entrez PY - 2012/8/7/pubmed PY - 2013/5/10/medline SP - 1726 EP - 32 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 27 IS - 11 N2 - BACKGROUND AND AIM: People with cirrhosis are at increased risk of development of complications related to sedation. The aim of the present study was to compare the effects of sedation for upper gastrointestinal endoscopy (UGIE) with propofol and midazolam on psychometric tests and critical flicker frequency (CFF) in people with cirrhosis. METHODS: A total of 127 people with cirrhosis were randomized into three groups: propofol group (n = 40), midazolam group (n = 42) and no sedation (n = 45). All patients underwent CFF test and combination of psychometry (number connection test-A and B [NCT-A,B]; digit symbol test [DST], line tracing test [LTT] and serial dotting test [SDT]) at baseline and at 2 h post-endoscopy. CFF was done at 30 min and repeated every 30 min for 2 h. RESULTS: In the propofol group there was no deterioration in psychometry (NCT-A [55.6 ± 18.7 vs 56.4 ± 19.0 s], NCT-B [98.2 ± 35.1 vs 97.8 ± 34.6 s], DST [26.7 ± 5.7 vs 26.3 ± 5.3], LTT [112.9 ± 35.7 vs 113.7 ± 36.6 s], SDT [94.6 ± 34.1 vs 95.2 ± 34.5 s]). Significant deterioration from baseline (39.8 ± 2.9 Hz) was seen in CFF at 30 min (38.8 ± 2.3 Hz) and 1 h (39.2 ± 2.4 Hz), P = 0.01 but no difference thereafter. In the midazolam group, significant deterioration was observed on psychometry (NCT-A [56.0 ± 18.5 vs 60.4 ± 19.8 s], NCT-B [99.9 ± 29.1 vs 105.9.6 ± 30.3 s], DST [26.1 ± 4.7 vs 25.2 ± 4.3], LTT [129.1 ± 34.5 vs 132.9 ± 35.4 s], SDT [95.6 ± 34.2]). No deterioration was observed in psychometry and CFF in people with cirrhosis without sedation. CONCLUSIONS: Propofol sedation for UGIE was associated with earlier recovery compared with midazolam, which causes deterioration of psychometric tests and CFF for a longer time in comparison with propofol. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/22861074/Randomized_controlled_trial_for_endoscopy_with_propofol_versus_midazolam_on_psychometric_tests_and_critical_flicker_frequency_in_people_with_cirrhosis_ L2 - https://doi.org/10.1111/j.1440-1746.2012.07231.x DB - PRIME DP - Unbound Medicine ER -