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The Safety of Propofol Infusion Compared to Midazolam and Meperidine Intravenous Bolus for Patients Undergoing Double Balloon Enteroscopy

Sombat Treeprasertsuk MD, PhD*, Rungsun Rerknimitr MD*, Phonthep Angsuwatcharakon MD, MSc**, Wiriyaporn Ridtitid MD, MSc*, Kessarin Thanapirom MD*, Pradermchai Kongkam MD, MSc*, Yuwadee Ponuthai RN**, Vichai Viriyautsahakul MD, MSc***

Affiliation : * Division of Gastroenterology, Faculty of Medicine, Chulalongkortn University, Bangkok, Thailand ** Department of Anatomy, Faculty of Medicine, Chulalongkortn University, Bangkok, Thailand *** Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand


Objective : The double balloon enteroscopy (DBE) procedure is long and requires moderate sedation. We aim to determine whether the administration of propofol infusion is safe by comparing it to intravenous midazolam/meperidine in patients undergoing DBE. Material and Method: A prospective study with 48 patients was conducted at King Chulalongkorn Hospital randomizing (block of four) patients into two groups. In group 1, 28 patients were enrolled for intravenous midazolam/meperidine, and one patient was dropped out before underwent DBE due to hemodynamic instability. Therefore, 27 (n = 27) participants were included in Group 1. In group 2, 28 patients were enrolled for propofol infusion, and seven patients were dropped out before underwent DBE, five due to hemodynamic instability (n = 5), and two refused treatment (n = 2). Therefore, 21 (n = 21) participants were included in Group 2. Vital signs and oxygen saturation were regularly monitored.
Results : Mean  SD age of patients was 56.89.2 years, and 41.7% of patients were male. There was no difference in demographic data between the groups. For the safety profile, 25.9% of the midazolam/meperidine group and 33.3% of the propofol group developed hypotension and/or desaturation (p = 0.45). The patients’ satisfaction of group 1 and group 2 were 86.76.5% and 86.38.1%, respectively, and presented no significant difference (p = 0.89).
Conclusion : Propofol infusion is safe and shows no difference in outcome from the midazolam and meperidine sedation for the DBE procedure.

Keywords : Safety, Sedation, Propofol infusion, Double balloon enteroscopy (DBE), midazolam, meperidine


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