Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Propofol with and without Midazolam for Diagnostic Upper Gastrointestinal Endoscopies in Children

  • Akbulut, Ulas Emre (Department of Pediatric Gastroenterology Hepatology and Nutrition, University of Health Sciences, Antalya Education and Research Hospital) ;
  • Kartal, Seyfi (Department of Anesthesiology and Intensive Care Medicine, University of Health Sciences, Kanuni Training and Research Hospital) ;
  • Dogan, Ufuk (Department of Anesthesiology and Intensive Care Medicine, University of Health Sciences, Kanuni Training and Research Hospital) ;
  • Akcali, Gulgun Elif (Department of Anesthesiology and Intensive Care Medicine, University of Health Sciences, Kanuni Training and Research Hospital) ;
  • Kalayci, Serap (Department of Anesthesiology and Intensive Care Medicine, University of Health Sciences, Kanuni Training and Research Hospital) ;
  • Kirci, Hulya (Department of Pediatric Gastroenterology Hepatology and Nutrition, University of Health Sciences, Kanuni Training and Research Hospital)
  • Received : 2018.05.30
  • Accepted : 2018.12.11
  • Published : 2019.05.15
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Abstract

Purpose: Various publications on the use of sedation and anesthesia for diagnostic procedures in children have demonstrated that no ideal agent is available. Although propofol has been widely used for sedation during esophagogastroduodenoscopy in children, adverse events including hypoxia and hypotension, are concerns in propofol-based sedation. Propofol is used in combination with other sedatives in order to reduce potential complications. We aimed to analyze whether the administration of midazolam would improve the safety and efficacy of propofol-based sedation in diagnostic esophagogastroduodenoscopies in children. Methods: We retrospectively reviewed the hospital records of children who underwent diagnostic esophagogastroduodenoscopies during a 30-month period. Demographic characteristics, vital signs, medication dosages, induction times, sedation times, recovery times, and any complications observed, were examined. Results: Baseline characteristics did not differ between the midazolam-propofol and propofol alone groups. No differences were observed between the two groups in terms of induction times, sedation times, recovery times, or the proportion of satisfactory endoscopist responses. No major procedural complications, such as cardiac arrest, apnea, or laryngospasm, occurred in any case. However, minor complications developed in 22 patients (10.7%), 17 (16.2%) in the midazolam-propofol group and five (5.0%) in the propofol alone group (p=0.010). Conclusion: The sedation protocol with propofol was safe and efficient. The administration of midazolam provided no additional benefit in propofol-based sedation.

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References

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