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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.64 (2018) >
Please use this identifier to cite or link to this item:
http://ir.fmu.ac.jp/dspace/handle/123456789/709
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| Title: | Propofol is a more effective and safer sedative agent than midazolam in endoscopic injection sclerotherapy for esophageal varices in patients with liver cirrhosis: a randomized controlled trial |
| Authors: | Watanabe, Ko
Hikichi, Takuto
Takagi, Tadayuki
Suzuki, Rei
Nakamura, Jun
Sugimoto, Mitsuru
Kikuchi, Hitomi
Konno, Naoki
Takasumi, Mika
Sato, Yuki
Hashimoto, Minami
Irie, Hiroki
Obara, Katsutoshi
Ohira, Hiromasa |
| Affiliation: | 内視鏡診療部
消化器内科学講座
消化器内視鏡先端医療支援講座 |
| Source title: | Fukushima Journal of Medical Science |
| Volume: | 64 |
| Issue: | 3 |
| Start page: | 133 |
| End page: | 141 |
| Issue Date: | 2018 |
| Abstract: | Objective: The efficacy of sedation during endoscopic injection sclerotherapy (EIS) for esophageal varices (EVs) in patients with liver cirrhosis remains unclear. The aim of this study is to compare the efficacy and safety between propofol- and midazolam-based sedation for EIS. Methods: Twenty-three patients with EVs were prospectively and randomly assigned to midazolam-based (Midazolam group) or propofol-based (Propofol group) sedation. All patients underwent a number connection test (NCT) to evaluate minimal hepatic encephalopathy (MHE) on the day before and at 2 and 24 hours following EIS. The primary endpoint was exacerbation of MHE after EIS, which was defined as deterioration of the NCT. The secondary endpoints were postoperative awareness, technical success rate, frequency of body movement, patient and operator satisfaction, cardiorespiratory dynamics during EIS, and adverse events. Results: Exacerbations of MHE at 2 hours after EIS compared with those before EIS were not significantly different between the two groups. In both groups, the deterioration of NCT scores before and 2 hours after EIS was observed (Propofol group: 60.0 vs. 70.0 s, P = 0.026; Midazolam group: 42.5 vs. 67.0 s, P = 0.002). There were no significant differences in awareness, technical success rate, or patient satisfaction. However, the frequency of body movement in the Propofol group was significantly lower than that in the Midazolam group (1 vs. 4, P = 0.045), and operator satisfaction in the Propofol group was significantly higher than that in the Midazolam group (P = 0.016). No adverse events were observed. Conclusions: Propofol-based sedation exacerbated MHE after EIS similarly to midazolam-based sedation in patients with liver cirrhosis. However, propofol-based sedation provided stable sedation with a lower frequency of body movements and high operator satisfaction. |
| Publisher: | The Fukushima Society of Medical Science |
| Publisher (Alternative foam): | 福島医学会 |
| language: | eng |
| URI: | http://ir.fmu.ac.jp/dspace/handle/123456789/709 |
| Full text URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/709/1/FksmJMedSci_64_p133.pdf |
| ISSN: | 0016-2590
2185-4610 |
| DOI: | 10.5387/fms.2018-21 |
| PubMed ID: | 30344206 |
| Related Page: | https://doi.org/10.5387/fms.2018-21 |
| Rights: | © 2018 The Fukushima Society of Medical Science |
| Appears in Collections: | Vol.64 (2018)
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