Propofol Deep Sedation with and without Midazolam for Percutaneous Radiofrequency Ablation in Patients with Hepatocellular Carcinoma: A Retrospective Cohort Study
Somchai Amornyotin MD1, Krongthip Sripunjan RN1
Affiliation : 1 Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : The study is aimed to evaluate and compare clinical efficacy of propofol deep sedation [PDS] with and without
midazolam for percutaneous radiofrequency ablation [RFA] in adult patients with hepatocellular carcinoma in a radiology
unit of a teaching hospital, Thailand.
Materials and Methods : The authors undertook a retrospective review of RFA procedures. Patients were classified into two
groups: group P (PDS without midazolam) and group PM (PDS with midazolam). The primary outcome variable of the
study was the successful completion of procedure. Secondary outcome variable was sedation-related complication during
and immediately after the procedure.
Results : After matching patients’ characteristics and duration of procedure, there were 65 patients in group P and 194
patients in group PM. There were no significant differences in characteristics of patients, duration of procedure and
preprocedural problems between the two groups. All procedures were successfully completed. There were no significant
differences in overall complication rate and hemodynamic parameters including systolic and diastolic blood pressure, heart
rate and oxygen saturation between the two groups. However, hypotension and bradycardia in group P was relatively greater
than in group PM.
Conclusion : PDS with and without midazolam for RFA in patients with hepatocellular carcinoma with appropriate monitoring
is relatively safe and effective. Clinical efficacy of PDS with midazolam for this procedure is not different or greater than in
PDS without midazolam. No serious complication is noted.
Keywords : Deep sedation, Propofol, Midazolam, Radiofrequency ablation, Hepatocellular carcinoma
