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Randomized Controlled Trial for Endoscopy with Propofol versus Midazolam on Psychometric tests and Critical Flicker Frequency in Cirrhotics.
Journal of Gastroenterology and Hepatology, 08/16/2012
Clinical Article
Amit A et al. – Propofol sedation for upper gastrointestinal endoscopy (UGIE) associated with earlier recovery compared to midazolam which causes deterioration of psychometric tests and critical flicker frequency (CFF) for a longer time in comparison with propofol.
Methods- 127 cirrhotic patients randomized into 3 groups, propofol group (n = 40), midazolam group(n=42) and no sedation (n=45).
- All patients underwent CFF test and combination of psychometry [number connection test-A and B(NCT-A,B); digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT) at baseline and at 2 hours post endoscopy.
- CFF done at 30 min and repeated every 30 min for 2 hours.
- In propofol group there was no deterioration in psychometry [NCT-A(55.6 ± 18.7 vs 56.4 ± 19.0 sec),NCT-B(98.2 ± 35.1 vs 97.8± 34.6 sec), DST(26.7±5.7 vs 26.3 ±5.3), LTT( 112.9 ± 35.7 vs 113.7 ± 36.6 sec),SDT (94.6 ±34.1 vs 95.2± 34.5 sec).
- Significant deterioration from baseline (39.8 ±2.9.Hz) was seen in CFF at 30 min (38.8± 2.3 Hz) and 1 hr (39.2± 2.4 Hz), p=0.01 but no difference thereafter.
- In midazolam group significant deterioration was observed on psychometry [NCT-A (56.0 ±18.5 vs 60.4 ±19.8 sec),NCT-B(99.9 ± 29.1 vs 105.9.6±30.3 sec), DST(26.1±4.7 vs25.2 ±4.3), LTT (129.1±34.5 vs132.9±35.4sec), SDT (95.6 ±34.2).
- No deterioration observed in psychometry and CFF in cirrhotics without sedation.
