초록 열기/닫기 버튼
Background/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxicalreactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients whopreviously experienced paradoxical reactions. Methods: This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions tomidazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation)or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction. Results: A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II(n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did notdiffer between groups. Conclusions: Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam wasreadministered.
