A Comparative Study Using Propofol Alone Versus Propofol Combined Midazolam for Colonoscopy: Randomized Double-Blind Study

Abstract

Background/Aims: Propofol provides several benefits over benzodiazepine as a sedative medication for endoscopic procedures, including faster recovery and improved patient satisfaction. Recent studies indicate that propofol and midazolam act synergistically in combination and therefore may be superior to sedation with propofol alone in terms of sedating efficacy and costs. We investigated the effect of propofol alone and combined use of propofol and midazolam in conscious sedation during colonoscopy. Methods: The double blind, randomized controlled trial was carried out to compare patients' and endoscopists' assessments in both groups of patients: P (propofol alone) group (n = 108) received propofol (2∼2.5 ml/kg/hr) plus normal saline (3 ml) and MP (propofol/midazolam) group (n = 102) received propofol (2∼2.5 ml/kg/hr) plus midazolam (3 mg). We compared followings in both groups; 1) induction and total propofol dosage 2) induction and procedure time 3) recovery time 4) satisfaction of patients and doctors 5) adverse effects. Results: There was no significant difference between two groups in baseline characteristics. Induction (9 vs. 12 ml) and total (17 vs. 22 ml) propofol dosage were lower in MP group than P group (p < 0.05). Induction (3.6 vs. 5.5 min) and procedure time were shorter in MP group than P group (p < 0.05). In both groups, significant difference was not observed in decreased of blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate. There was no significant difference of recovery time and content of patients. The incidence of adverse effect was not different in the two groups. Fatal adverse effect was not found in both groups. Conclusions: Both propofol alone and propofol combined midazolam are safe and reasonable sedation methods for colonoscopy. Combined use of propofol and midazolam is more effective sedative method than use of propofol alone because of rapid induction and lower propofol dosage without increasing adverse effects.