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Vol.64 (2018) >

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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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