Clinical Endoscopy

  • 제55권2호
  • /
  • Pages.234-239
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam

  • Ji Hyung Nam (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Dong Kee Jang (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Jun Kyu Lee (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Hyoun Woo Kang (Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine) ;
  • Byung-Wook Kim (Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Byung Ik Jang (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Committees of Quality Management and Conscious Sedation of Korean Society of Gastrointestinal Endoscopy (Korean Society of Gastrointestinal Endoscopy)
  • 투고 : 2021.04.14
  • 심사 : 2021.05.19
  • 발행 : 2022.03.30
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초록

Background/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxical reactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients who previously experienced paradoxical reactions. Methods: This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions to midazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation) or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction. Results: A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II (n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did not differ between groups. Conclusions: Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam was readministered.

키워드

과제정보

This study was supported by a 2017 Weolbong grant from the Korean Gastrointestinal Endoscopy Research Foundation.

참고문헌

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