Background and Aims

The safest and most efficient method of sedation for outpatient colonoscopy remains unclear. This study aimed to compare the efficiency and safety of bolus administration of midazolam compared with titrated administration and propofol administration for patients undergoing outpatient colonoscopy.

Methods

We randomly divided patients undergoing colonoscopy into the propofol group, bolus midazolam group, and titrated midazolam group. We compared total procedure time, induction time, recovery time, and discharge time among the 3 groups. We also compared patient satisfaction and the incidence of adverse events.

Results

In total, 267 patients (89 in each study group) were enrolled during the study period. Patients in the propofol group had a shorter total procedure time (39.5 vs 59.4 vs 58.1 minutes; P < .001), induction time (4.6 vs 6.3 vs 7.6 minutes; P < .001), recovery time (11.5 vs 29.5 vs 29.2 minutes; P < .001), and discharge time (20.6 vs 34.9 vs 34.7 minutes; P < .001) than patients in the bolus midazolam group and titrated midazolam group. Patients in the propofol group reported higher degrees of satisfaction than patients in the bolus or titrated midazolam plus meperidine groups (9.9 vs 9.6 vs 9.6 [P = .007] and 4.9 vs 4.7 vs 4.8 [P = .008], respectively). Adverse events were not significantly different between groups.

Conclusions

In this randomized trial, propofol was superior to bolus or titrated midazolam in terms of endoscopy unit efficiency and patient satisfaction during outpatient colonoscopy. (Clinical trial registration number: KCT0002805.)

中文翻译：

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丙泊酚与推注和滴定咪达唑仑在门诊结肠镜检查中镇静作用的比较：一项前瞻性随机双盲研究。

背景和目标

门诊结肠镜检查安全和最有效的镇静方法仍不清楚。本研究旨在比较咪达唑仑推注给药与滴定给药和丙泊酚给药相比，对于接受门诊结肠镜检查的患者的有效性和安全性。

方法

我们将接受结肠镜检查的患者随机分为丙泊酚组、咪达唑仑推注组和咪达唑仑滴定组。我们比较了 3 组的总手术时间、诱导时间、恢复时间和出院时间。我们还比较了患者满意度和不良事件的发生率。

结果

在研究期间，总共招募了 267 名患者（每个研究组 89 名）。丙泊酚组患者的总手术时间较短（39.5 对 59.4 对 58.1 分钟；P  <.001）、诱导时间（4.6 对 6.3 对 7.6 分钟；P  <.001）、恢复时间（11.5 对 29.5 对 29.2 分钟） ; P  <.001）和出院时间（20.6 分钟 vs 34.9 分钟 vs 34.7 分钟；P  <.001）与推注咪达唑仑组和滴定咪达唑仑组的患者相比。丙泊酚组的患者报告的满意度高于推注或滴定咪达唑仑加哌替啶组的患者（9.9 vs 9.6 vs 9.6 [ P  = .007] 和 4.9 vs 4.7 vs 4.8 [ P = .008]，分别）。不良事件在组间没有显着差异。

结论

在这项随机试验中，就门诊结肠镜检查期间的内窥镜检查单元效率和患者满意度而言，丙泊酚优于推注或滴定咪达唑仑。（临床试验注册号：KCT0002805。）