Endoscopy 2000; 32(9): 677-682
DOI: 10.1055/s-2000-9021
Original Article
Georg Thieme Verlag Stuttgart · New York

Propofol Versus Midazolam for Conscious Sedation Guided by Processed EEG During Endoscopic Retrograde Cholangiopancreatography: A Prospective, Randomized, Double-Blind Study

P. Krugliak 1 , B. Ziff 1 , Y. Rusabrov 2 , A. Rosenthal 1 , A. Fich 1 , G. M.Gurman 2
  • 1 Dept. of Gastroenterology, Soroka Medical Center of Kupat Holim and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
  • 2 Division of Anesthesiology, Soroka Medical Center of Kupat Holim and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Further Information

Publication History

Publication Date:
31 December 2000 (online)

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Background and Study Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure, which requires appropriate sedation. The aim of this prospective, randomized, double-blind study was to compare the quality and characteristics of sedation with midazolam or propofol in patients undergoing ERCP.

Patients and Methods: A total of 32 patients undergoing ERCP were randomly allocated for sedation with propofol (n = 15) or midazolam (n = 17). Blood pressure, heart rate, and O2 saturation were monitored. Sedation was maintained at near constant levels by use of the spectral edge frequency (SEF) technique, an EEG-based method for measuring the depth of sedation. Clinical variables, patient cooperation, time to recovery, and amnesia served as outcome variables.

Results: There was no significant difference between the two study groups in patient characteristics. The „target SEF” was 13.6 ± 0.7 Hz for the propofol group and 14.8 ± 1.1 Hz for the midazolam group (n.s.). The only clinical parameter with a significant difference between the groups was the percent of time in which the heart rate deviated more than 20 % from baseline for at least 2 minutes, i.e. 14.6 ± 2.0 % for propofol and 48.2 ± 38.0 % for midazolam (P < 0.01). Patient cooperation was better in the propofol group than in the midazolam group (full cooperation, 13/15 vs. 1/17, respectively; P < 0.001). Patient recovery was significantly quicker in the propofol group (P< 0.001). The degree of amnesia was similar in both groups; no patient in either group remembered details of the procedure.

Conclusions: ERCP is better tolerated by patients sedated with propofol compared with midazolam, with a shorter recovery time and lesser hemodynamic side effects. Propofol should be considered to be the sedative drug of choice for ERCP.

References

M.D. G. M. Gurman,

Division of Anesthesiology Soroka Medical Center

Beer Sheva

Israel 84101

Phone: + 972-7-6480391

Email: gurman@bgumail.bgu.ac.il