Browse > Article
http://dx.doi.org/10.5946/ce.2011.44.1.22

Comparison of Midazolam Alone versus Midazolam Plus Propofol during Endoscopic Submucosal Dissection  

Cho, Young-Shim (Department of Internal Medicine, Chungbuk National University College of Medicine)
Seo, Eui-Keun (Department of Internal Medicine, Chungbuk National University College of Medicine)
Han, Jung-Ho (Department of Internal Medicine, Chungbuk National University College of Medicine)
Yoon, Soon-Man (Department of Internal Medicine, Chungbuk National University College of Medicine)
Chae, Hee-Bok (Department of Internal Medicine, Chungbuk National University College of Medicine)
Park, Seon-Mee (Department of Internal Medicine, Chungbuk National University College of Medicine)
Youn, Sei-Jin (Department of Internal Medicine, Chungbuk National University College of Medicine)
Publication Information
Clinical Endoscopy / v.44, no.1, 2011 , pp. 22-26 More about this Journal
Abstract
Background/Aims: For proper sedation during endoscopic submucosal dissection (ESD), propofol has been widely used. This study aimed to compare the levels of sedation and tolerance of patients treated with midazolam (M group) and a combination of midazolam and propofol (MP group) during ESD. Methods: A total of 44 consecutive patients undergoing ESD were randomly assigned to the two groups. In the M group, 2 mg of midazolam was given repeatedly to maintain after a loading dose of 5 mg. The MP group initially received 5 mg of midazolam and 20 mg of propofol. Then, we increased the dosage of propofol by 20 mg gradually. Results: The average amount of midazolam was 12 mg in the M group. In the M group, 10 patients were given propofol additionally, since they failed to achieve proper sedation. The average amount of propofol was 181 mg in the MP group. Procedure time, vital signs and rates of complications were not significantly different between two groups. Movement of patients and discomfort were lower in the MP group. Conclusions: During ESD, treatment with propofol and a low dose of midazolam for sedation provides greater satisfaction for endoscopists compared to midazolam alone.
Keywords
Endoscopic submucosal dissection; Sedation; Midazolam; Propofol;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Practice guidelines for sedation and analgesia by non-anesthesiologists. A report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Anesthesiology 1996;84:459-471.   DOI   ScienceOn
2 Chokhavatia S, Nguyen L, Williams R, Kao J, Heavner JE. Sedation and analgesia for gastrointestinal endoscopy. Am J Gastroenterol 1993; 88:393-396.
3 Gamble JA, Kawar P, Dundee JW, Moore J, Briggs LP. Evaluation of midazolam as an intravenous induction agent. Anaesthesia 1981;36: 868-873.   DOI   ScienceOn
4 Al-Khudhairi D, Whitwam JG, McCloy RF. Midazolam and diazepam for gastroscopy. Anaesthesia 1982;37:1002-1006.   DOI   ScienceOn
5 Sebel PS, Lowdon JD. Propofol: a new intravenous anesthetic. Anesthesiology 1989;71:260-277.   DOI   ScienceOn
6 Keeffe EB, O'Connor KW. 1989 A/S/G/E survey of endoscopic sedation and monitoring practices. Gastrointest Endosc 1990;36(3 Suppl): S13-S18.
7 Bell GD. Premedication, preparation, and surveillance. Endoscopy 2000;32:92-100.   DOI   ScienceOn
8 Carlsson U, Grattidge P. Sedation for upper gastrointestinal endoscopy: a comparative study of propofol and midazolam. Endoscopy 1995;27: 240-243.   DOI   ScienceOn
9 Koo JS, Choi JH, Jung SW, et al. Conscious sedation with midazolam combined with propofol for colonoscopy. Korean J Gastrointest Endosc 2007;34:298-303.
10 Jung M, Hofmann C, Kiesslich R, Brackertz A. Improved sedation in diagnostic and therapeutic ERCP: propofol is an alternative to midazolam. Endoscopy 2000;32:233-238.   DOI   ScienceOn
11 McClune S, McKay AC, Wright PM, Patterson CC, Clarke RS. Synergistic interaction between midazolam and propofol. Br J Anaesth 1992; 69:240-245.   DOI   ScienceOn
12 Reimann FM, Samson U, Derad I, Fuchs M, Schiefer B, Stange EF. Synergistic sedation with low-dose midazolam and propofol for colonoscopies. Endoscopy 2000;32:239-244.   DOI   ScienceOn
13 Charlton JE. Monitoring and supplemental oxygen during endoscopy. BMJ 1995;310:886-887.   DOI   ScienceOn
14 Rex DK, Overley C, Kinser K, et al. Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases. Am J Gastroenterol 2002;97:1159-1163.   DOI   ScienceOn
15 Cho H, Kim YM, Oh JH, et al. The effect of propofol for conscious sedation during colonoscopy: a prospective, randomized study. Korean J Med 2005;69:30-38.
16 Kim MH, Doo YC, Yang SK, et al. The changes of SaO2 during upper endoscopy. Korean J Gastroenterol 1990;22:496-501.
17 Steffes CP, Sugawa C, Wilson RF, Hayward SR. Oxygen saturation monitoring during endoscopy. Surg Endosc 1990;4:175-178.   DOI   ScienceOn
18 Cummings GC, Dixon J, Kay NH, et al. Dose requirements of ICI 35,868 (propofol, 'Diprivan') in a new formulation for induction of anaesthesia. Anaesthesia 1984;39:1168-1171.   DOI   ScienceOn
19 Choi WH, Kim SW, Lee YS, et al. The effect of upper gastrointestinal endoscopy using conscious sedation with propofol. Korean J Med 2003; 64:509-515.
20 Patterson KW, Casey PB, Murray JP, O'Boyle CA, Cunningham AJ. Propofol sedation for outpatient upper gastrointestinal endoscopy: comparison with midazolam. Br J Anaesth 1991;67:108-111.   DOI   ScienceOn