Estudo comparativo de eficácia e segurança entre propofol e midazolam durante sedação para colonoscopia

Abstract

Objective: To compare safety and efficacy of propofol with midazolam for deep sedation in the colonoscopy. Methods: In a prospective way, 66 patients underwent colonoscopy - 50 patients received propofol in an average dose of 3,25 mg.kg-1 and 16 patients (control group) received midazolam with total average dose of 2,05 mg.kg-1. The dose of medication was titrated according to patient need. The analyzed cardiovascular and respiratory parameters were: oxygen saturation, systolic and diastolic blood pressure and heart rate. After the colonoscopy, a survey with a visual scale from 0 to 10 and questions regarding the pain, discomfort and satisfaction was applied. The statistics analyzed by the t Student test. Results: Groups were similar regarding the age, weight, sex and physical conditions (ASA grade). None of the patient required emergencial treatment. None of the cardiovascular and respiratory parameters with statistics differences produced hemodynamic repercussions. The pain and satisfaction parameters showed no significant difference between the midazolam group and propofol group The discomfort parameter during the colonoscopic showed significant difference (p=0,038) between the midazolam group (score 2,81) and propofol group (score 1,18) and all the patients wich had presented paradoxal excitation (25%) in this group reported discomfort. Conclusion: The cardiovascular and respiratory parameters variation, even when different between groups, didn't produced clinical repercussions. The pain and satisfaction parameters showed no significant difference between groups. It was demonstrated that the midazolam group referred more discomfort than the propofol group.