Association of Propofol Vs Midazolam in Adverse Effect for Sedation during ERCP

Abstract

Endoscopic Retrograde Cholangiopancreatography (ERCP): This is an invasive, diagnostic and therapeutic procedure for biliary and pancreatic disorders that requires adequate sedation to provide patient comfort and successful completion of the procedure. Two frequently used sedatives, midazolam and propofol, have different pharmacological properties and the selection of which remains controversial. This study aimed to check association between Propofol and Midazolam regarding adverse events in ERCP patients. A prospective observational study was conducted in a private clinical setting over four months, after ethics approval. The patients were convenience sampled, and 100 were randomly assigned equally to two groups – Propofol (n=50) and Midazolam (n=50) – age range of 18-90 years. Data was generated on modified proforma which included demographics, risk factors, sedation, recovery and postoperative safety and analysed with SPSS 27 and MS Excel using Chi-square. Baseline characteristics were comparable between the groups, and both propofol and midazolam were shown to be relatively safe sedatives used during ERCP with the majority of the patients having no major side effects. The two drugs did have some differences in toxicities. Patients treated with midazolam had a higher percentage without complications and patients treated with propofol had higher incidences of hypotension and hypoxia.