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Comparison of propofol with midazolam in endoscopic submucosal dissection for esophageal squamous cell carcinoma: a randomized controlled trial.
- Source :
-
Journal of gastroenterology [J Gastroenterol] 2018 Mar; Vol. 53 (3), pp. 397-406. Date of Electronic Publication: 2017 Jun 09. - Publication Year :
- 2018
-
Abstract
- Background: Interruption of sedation due to a poor response to modified neuroleptanalgesia (m-NLA) with midazolam often occurs during endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) because most patients have a history of heavy alcohol intake. Recently, propofol has been used feasibly and safely during endoscopic procedures. The aim of this study was to clarify the efficacy and safety of propofol compared with that of midazolam during ESD for ESCC.<br />Methods: This was a single-blind, randomized controlled trial in a single center. Patients with ESCC scheduled for ESD were included in the study. Patients were randomly assigned to one of two groups: the propofol group and the midazolam group. The main outcome was the incidence of discontinuation of the procedure due to a poor response to sedation. Secondary outcomes included risk factors for a poor response to sedation.<br />Results: Between April 2014 and October 2015, 132 patients (n = 66 per group) who underwent ESD for ESCC were enrolled in this study. The incidence of discontinuation due to a poor response to sedation in the propofol and midazolam groups was 0% (0/66) and 37.9% (25/66), respectively (p < 0.01). Multivariate analyses revealed that use of midazolam [Odds ratio (OR), 7.61; 95% confidence interval (CI), 2.64-21.92; p < 0.01] and age (OR, 0.93; 95% CI, 0.86-0.98; p < 0.01) were risk factors for a poor response to sedation.<br />Conclusions: Our study indicates that, compared with midazolam, propofol is a more efficient sedative for m-NLA during ESD for ESCC.
- Subjects :
- Aged
Alcohol Drinking adverse effects
Anesthetics, Intravenous adverse effects
Female
Hospitals, University
Humans
Japan
Logistic Models
Male
Midazolam adverse effects
Middle Aged
Multivariate Analysis
Propofol adverse effects
Single-Blind Method
Treatment Outcome
Anesthetics, Intravenous administration & dosage
Endoscopic Mucosal Resection
Esophageal Neoplasms surgery
Esophageal Squamous Cell Carcinoma surgery
Midazolam administration & dosage
Propofol administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1435-5922
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 28600597
- Full Text :
- https://doi.org/10.1007/s00535-017-1358-6