A COMPARATIVE-EVALUATION OF PROPOFOL AND MIDAZOLAM AS SEDATIVE AGENTSIN FIBEROPTIC BRONCHOSCOPY

Propofol, a new intravenous sedative agent, was investigated in 41 ast hmatic patients undergoing day-case (outpatient) fiberoptic bronchosco py. The study design was a randomized comparison between propofol and midazolam, which is a well-established intravenous sedative agent. The age, weight, and American Society of Anesthesiologists physical statu s and lung function of the two groups were not significantly different . Mean (SD) induction dose of propofol was 104.7 (30.1) mg with a main tenance dose of 121.9 (38.5) mg. Corresponding values of midazolam wer e 9.3 (3.1) mg and 3.7 (2.3) mg. The required level of sedation was ac hieved significantly faster with propofol, mean (SD) 125.4 (39.8) s, c ompared with midazolam, 179.4 (55.2) s (p<0.001). Significantly faster recovery was noted with propofol compared with midazolam in terms of time to recall name and date of birth 2.3 (1.7) min vs 6.3 (8.6) min, (p<0.045). Alertness scored with the digital symbol substitution test (DSST) returned to prebronchoscopy values in the propofol group at 30 min, DSST score = 35.9 (18.2) vs 13.4 (9.1), in the midazolam group (p <.0001) and was still significantly higher at 90 min-39.4 (17.9) and 2 3.1 (13.8) (p<0.01). We conclude that propofol is a useful sedating ag ent in fiberoptic bronchoscopy with similar efficacy to midazolam but with a faster onset of action and a more rapid recovery. These represe nt significant advantages for day-case procedures.