Propofol versus pethidine/midazolam sedation: benefits in flexible upper gastrointestinal endoscopy

There is a lack of evidence comparing the use of propofol as a single agent with pethidine/midazolam combined for sedation in upper gastrointestinal (GI) endoscopy in developing countries. The aim of this study was to compare the benefits of sedation using propofol as a single agent to pethidine combined with midazolam in Ghana. During the first 6 months of this study, all patients (137) undergoing diagnostic upper GI endoscopy at the Tamale Teaching Hospital (TTH) received pethidine/midazolam, and the following 6 months, all patients (104) received propofol. A total of 241 patients were enrolled in the study. The duration of the procedure and recovery time were recorded, and a structured questionnaire was then administered to determine patient satisfaction, level of sedation and amnesia. The mean time of recovery from sedation was significantly lower in propofol group than in pethidine and midazolam group (12.6 min vs. 33.7 min; p < 0.001). The duration of the procedure was significantly shorter by 4.4 min in the propofol group compared to the pethidine/midazolam group (4.6 min vs. 8.9 min p < 0.001). There was no association between the sedation method and the level of satisfaction ( p = 0.653). The use of propofol for conscious sedation during flexible upper gastrointestinal endoscopy is superior compared to the combined midazolam and pethidine in terms of benefits. The cost of propofol is slightly cheaper than combined midazalom and pethidine.