Pediatr Gastroenterol Hepatol Nutr.  2019 May;22(3):217-224. 10.5223/pghn.2019.22.3.217.

Propofol with and without Midazolam for Diagnostic Upper Gastrointestinal Endoscopies in Children

• Akbulut UE
• Kartal S
• Dogan U
• Akcali GE
• Kalayci S
• Kirci H

• KMID: 2444847
• DOI: http://doi.org/10.5223/pghn.2019.22.3.217

Abstract

PURPOSE
Various publications on the use of sedation and anesthesia for diagnostic procedures in children have demonstrated that no ideal agent is available. Although propofol has been widely used for sedation during esophagogastroduodenoscopy in children, adverse events including hypoxia and hypotension, are concerns in propofol-based sedation. Propofol is used in combination with other sedatives in order to reduce potential complications. We aimed to analyze whether the administration of midazolam would improve the safety and efficacy of propofol-based sedation in diagnostic esophagogastroduodenoscopies in children.
METHODS
We retrospectively reviewed the hospital records of children who underwent diagnostic esophagogastroduodenoscopies during a 30-month period. Demographic characteristics, vital signs, medication dosages, induction times, sedation times, recovery times, and any complications observed, were examined.
RESULTS
Baseline characteristics did not differ between the midazolam-propofol and propofol alone groups. No differences were observed between the two groups in terms of induction times, sedation times, recovery times, or the proportion of satisfactory endoscopist responses. No major procedural complications, such as cardiac arrest, apnea, or laryngospasm, occurred in any case. However, minor complications developed in 22 patients (10.7%), 17 (16.2%) in the midazolam-propofol group and five (5.0%) in the propofol alone group (p=0.010).
CONCLUSION
The sedation protocol with propofol was safe and efficient. The administration of midazolam provided no additional benefit in propofol-based sedation.

Keyword

Conscious sedation; Endoscopy; Propofol; Midazolam; Children

MeSH Terms

Anesthesia
Anoxia
Apnea
Child*
Conscious Sedation
Endoscopy
Endoscopy, Digestive System
Endoscopy, Gastrointestinal*
Heart Arrest
Hospital Records
Humans
Hypnotics and Sedatives
Hypotension
Laryngismus
Midazolam*
Propofol*
Retrospective Studies
Vital Signs
Hypnotics and Sedatives
Midazolam
Propofol

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