Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy Systematic review and meta-analysis

Abstract

Background: Sedation with etomidate or propofol alone during gastroscopy has many side effects. A systematic review and meta-analysis were conducted to evaluate the safety and efficacy of the combined use of propofol and etomidate for sedation during gastroscopy. Methods: PubMed, Embase, Medline (via Ovid SP), Cochrane library databases, CINAHL (via EBSCO), China Biology Medicine disc (CBMdisc), Wanfang, VIP, and China National Knowledge Infrastructure (CNKI) databases were systematically searched. We included randomized controlled trials (RCTs) comparing the combined use of propofol and etomidate vs etomidate or propofol alone for sedation during gastroscopy. Data were pooled using the random-effects models or fixed-effect model based on heterogeneity. Results: Fifteen studieswith 2973 participantswere included in the analysis. Compared to propofol alone, the combined use of propofol and etomidate possibly increased recovery time (SMD=0.14, 95% CI=0.04-0.24; P=.005), and the risk formyoclonus (OR=3.07, 95% CI=1.73-5.44; P