Propofol versus Midazolam for Sedation during Esophagogastroduodenoscopy in Children
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Background/Aims: To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children. Methods: We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from thirty four consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures. Results: There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30±16.41 minutes) compared with midazolam group (58.89±17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04±19.92 and 97.82±16.7) compared with propofol group (110.26±20.14 and 83.26±12.33) (p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures. Conclusions: Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.
Abstract
Background/Aims: To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children. Methods: We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from thirty four consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures. Results: There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30±16.41 minutes) compared with midazolam group (58.89±17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04±19.92 and 97.82±16.7) compared with propofol group (110.26±20.14 and 83.26±12.33) (p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures. Conclusions: Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.
참고문헌 (22)
- Hertzog JH, "Propofol anesthesia for invasive procedures in ambulatory and hospitalized children: experience in the pediatric intensive care unit", Pediatrics, 103, pp.E30~ (1999)
- Squires RH Jr, "Efficacy, safety, and cost of intravenous sedation versus general anesthesia in children undergoing endoscopic procedures", Gastrointest Endosc, 41, pp.99~104 (1995)
- Lightdale JR, "Efficiency of propofol versus midazolam and fentanyl sedation at a pediatric teaching hospital: a prospective study", Gastrointest Endosc, 67, pp.1067~1075 (2008)
- Abu-Shahwan I, "Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy", Paediatr Anaesth, 17, pp.460~463 (2007)
- Oei-Lim VL, "Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol", Eur J Anaesthesiol, 15, pp.535~543 (1998)
- Barbi E, "Deep sedation with propofol for upper gastrointestinal endoscopy in children, administered by specially trained pediatricians: a prospective case series with emphasis on side effects", Endoscopy, 38, pp.368~375 (2006)
- Morse JW, "Endoscopist-administered propofol: a retrospective safety study", Can J Gastroenterol, 22, pp.617~620 (2008)
- Cohen LB, "Propofol for endoscopic sedation: a protocol for safe and effective administration by the gastroenterologist", Gastrointest Endosc, 58, pp.725~732 (2003)
- American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists, "Practice guidelines for sedation and analgesia by non-anesthesiologists", Anesthesiology, 96, pp.1004~1017 (2002)
- van Beek EJ, "Safe and effective procedural sedation for gastrointestinal endoscopy in children", J Pediatr Gastroenterol Nutr, 54, pp.171~185 (2012)
- Elitsur Y, "Propofol sedation for endoscopic procedures in children", Endoscopy, 32, pp.788~791 (2000)
- Disma N, "Propofol sedation with fentanyl or midazolam during oesophagogastroduodenoscopy in children", Eur J Anaesthesiol, 22, pp.848~852 (2005)
- Fredette ME, "Endoscopic sedation in pediatric practice", Gastrointest Endosc Clin N Am, 18, pp.739~751 (2008)
- von Delius S, "Midazolampain, but one cannot remember it: a survey among Southern German endoscopists", Eur J Gastroenterol Hepatol, 19, pp.465~470 (2007)
- Lamireau T, "Oxygen saturation during esophagogastroduodenoscopy in children: general anesthesia versus intravenous sedation", J Pediatr Gastroenterol Nutr, 27, pp.172~175 (1998)
- Lazzaroni M, "Preparation, premedication and surveillance", Endoscopy, 35, pp.103~111 (2003)
- Rex DK, "Endoscopist-directed administration of propofol: a worldwide safety experience", Gastroenterology, 137, pp.1229~1237 (2009)
- Cravero JP, "qThe incidence and nature of adverse events during pediatric sedation", anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium, 2009, pp.108, 795~804
- Khoshoo V, "Propofol versus midazolam plus meperidine for sedation during ambulatory esophagogastroduodenoscopy", J Pediatr Gastroenterol Nutr, 37, pp.146~149 (2003)
- Mencía SB, "Analgesia and sedation in children: practical approach for the most frequent situations", J Pediatr (Rio J), 83(2 Suppl), pp.S71~S82 (2007)
- Paspatis GA, "Synergistic sedation with oral midazolam as a premedication and intravenous propofol versus intravenous propofol alone in upper gastrointestinal endoscopies in children: a prospective, randomized study", J Pediatr Gastroenterol Nutr, 43, pp.195~199 (2006)
- Jalota L, "Prevention of pain on injection of propofol: systematic review and meta-analysis", BMJ, 342, pp.d1110~ (2011)
