Low Dose Midazolam versus Propofol for Conscious Sedation During Diagnostic Endoscopy for Day Case Surgery: A randomized clinical trial

Background: As endoscopy is an invasive and painful procedure, it is necessary to use a suitable sedative in terms of anesthetic efficacy. There is a lack of evidence comparing the use of propofol versus midazolam for sedation in endoscopy in developing countries. Objective: To compare low-dose midazolam versus propofol in terms of time required for achieving conscious sedation and time to recovery in patients undergoing diagnostic endoscopy for day-case surgery. Method: The study was a randomized controlled trial. One hundred patients who met the inclusion criteria were enrolled and split into two groups of fifty each at random by computer-generated allocation sequence after providing written informed permission. Propofol was given to patients in group B, while midazolam was given to patients in group A. Endoscopy was performed after the time to conscious sedation was recorded. Following that, recovery time was noted, and as the data was non-normal in distribution, outcome measures between both groups were compared using the Mann-Whitney U test. Results: The median age of patients in the midazolam group was 42.5 (IQR: 18) years and in the propofol group was 39 (IQR: 16.25) years. The median time to conscious sedation in the midazolam group was 2.5 (IQR: 1) minutes, and in the propofol group, it was 2 (IQR: 1) minutes. (p=0.04). The propofol group's median recovery time was 16 (IQR: 3) minutes, while the midazolam group's was 18 (IQR: 3) minutes (p < 0.001). Conclusion: In patients who underwent diagnostic endoscopy, propofol was significantly associated with shorter time to achieve conscious sedation and recovery compared to midazolam.