Comparison of the effects and side-effects of sedation with propofol versus midazolam plus pethidine in patients undergoing endoscopy in Imam Khomeini Hospital, Ahvaz

Introduction
Gastrointestinal endoscopy is an invasive and diagnostic procedure that causes the patients considerable pain, discomfort, and anxiety. Therefore, various types of sedation and analgesia techniques have been used during the procedure.

Aim
To compare the effects and side-effects of sedation with propofol versus midazolam plus pethidine in patients undergoing endoscopy.

Material and Methods
This is a randomised controlled double-blind clinical trial study conducted on 272 patients undergoing diagnostic and treatment endoscopy and colonoscopy in Imam Khomeini Hospital in Ahvaz between 2017 and 2018. The patients were randomly assigned to two groups. Patients in the first group (n = 136) received propofol with midazolam and ketamine, and the second group (n = 136) received pethidine and midazolam. Study outcome measures included the recovery time, patient satisfaction, quality of sedation, and adverse events.

Results
The occurrence of complications was higher in the propofol group (25% vs. 0%; p = 0.0001). No serious adverse events were observed in the study groups. Overall patient satisfaction and quality of sedation assessment scores in the propofol group were significantly better than those seen in the pethidine-midazolam group (p = 0.012 and p = 0.001, respectively). Recovery time was statistically shorter in the propofol-midazolam group (6.05 ±1.62 min) compared to the pethidine-midazolam group (6.72 ±2.21 min) (p = 0.006).

Conclusions
Propofol-midazolam can provide better sedation, patient satisfaction, and recovery than pethidine-midazolam during endoscopy. Therefore, it can be recommended in patients scheduled for diagnostic and treatment endoscopy.