Sedation for upper gastrointestinal endoscopy: a comparative study of propofol and midazolam

Endoscopy. 1995 Mar;27(3):240-3. doi: 10.1055/s-2007-1005678.


Background and study aims: A benzodiazepine is generally used when sedation is required for endoscopy, whilst the newer agent propofol appears to have a more suitable pharmacokinetic profile. The aim of this study was to compare the quality of sedation provided by midazolam and propofol under controlled conditions.

Patients and methods: Ninety healthy outpatients requesting sedation at diagnostic gastroscopy were prospectively randomized to receive a bolus dose of either midazolam 0.06 mg/kg or propofol 0.6 mg/kg, followed by repeat doses of 50% of the initial dose as required. No topical anesthesia was used. The endoscopist and the patient replied to a questionnaire.

Results: Patients receiving propofol tolerated endoscopy better (p = 0.01); reached a deeper maximum level of sedation (p = 0.001); and recovered more rapidly (p = 0.001). There was a similar frequency of amnesia for the procedure (propofol 67% vs. midazolam 65%); of oxygen desaturation (four patients in each group, < 85%); and of perceived patient comfort (p = 0.5).

Conclusions: Compared to midazolam, propofol facilitated gastroscopy to a greater extent. However, due to its narrower therapeutic range, propofol is the more demanding agent to administer, thus making it less universally applicable than midazolam.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Confidence Intervals
  • Conscious Sedation* / adverse effects
  • Conscious Sedation* / methods
  • Endoscopy, Gastrointestinal*
  • Female
  • Humans
  • Male
  • Midazolam*
  • Middle Aged
  • Propofol*
  • Prospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome


  • Midazolam
  • Propofol