Optimizing Sedation for Upper GI Endoscopy: Propofol versus Midazolam: A Clinical Study at Sirte Oncology Central

Abstract

Upper gastrointestinal (GI) endoscopy is a common diagnostic and therapeutic procedure, typically performed under conscious sedation to improve patient comfort and cooperation. However, the choice of sedative remains a topic of ongoing debate. This study aimed to compare the safety and efficacy of midazolam and propofol for sedation during upper GI endoscopy. A total of 80 patients scheduled for elective upper GI endoscopy at the Endoscopy Unit of our hospital between February 2023 and October 2023 were recruited for this prospective, randomized controlled trial. Patients were randomly assigned to two equal groups: one group received propofol, while the other received midazolam. The anesthesiologist was aware of the sedative agent being administered, but the patients were blinded to the treatment. Both sedatives were administered via intravenous bolus, with dosages adjusted as needed to maintain an appropriate level of sedation. The recovery time was significantly shorter in the propofol group compared to the midazolam group. While the propofol group exhibited a decrease in systolic blood pressure, this was transient and did not result in significant adverse effects. In contrast, the midazolam group experienced a notable reduction in oxygen saturation, with a higher incidence of hypoxia compared to the propofol group. No major adverse events, such as cardiac arrhythmias or respiratory depression, were observed in either group during the procedure. The sedation quality, as assessed by the Observer's Assessment of Alertness and Sedation (OAA/S) scale, was stable throughout the procedure in the propofol group, while some variability was noted in the midazolam group. The results of this study suggest that propofol is a more effective and safer sedative agent than midazolam for upper GI endoscopy. Propofol offers faster recovery times and more stable sedation, with fewer complications related to oxygen saturation. It is therefore recommended as the sedative of choice for upper GI endoscopy, although careful monitoring of blood pressure is essential