Zuo XL, Li Z, Liu XP, Li CQ, Ji R, Wang P, Zhou CJ, Liu H, Li YQ. Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: A randomized trial. World J Gastroenterol 2012; 18(15): 1814-1821 [PMID: 22553407 DOI: 10.3748/wjg.v18.i15.1814]
Corresponding Author of This Article
Dr. Yan-Qing Li, Professor, Department of Gastroenterology, Qilu Hospital, Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, Shandong Province, China. liyanqing@sdu.edu.cn
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Zuo XL, Li Z, Liu XP, Li CQ, Ji R, Wang P, Zhou CJ, Liu H, Li YQ. Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: A randomized trial. World J Gastroenterol 2012; 18(15): 1814-1821 [PMID: 22553407 DOI: 10.3748/wjg.v18.i15.1814]
World J Gastroenterol. Apr 21, 2012; 18(15): 1814-1821 Published online Apr 21, 2012. doi: 10.3748/wjg.v18.i15.1814
Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: A randomized trial
Xiu-Li Zuo, Zhen Li, Xiao-Ping Liu, Chang-Qing Li, Rui Ji, Peng Wang, Cheng-Jun Zhou, Han Liu, Yan-Qing Li
Xiu-Li Zuo, Zhen Li, Chang-Qing Li, Rui Ji, Peng Wang, Han Liu, Yan-Qing Li, Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Xiao-Ping Liu, Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Cheng-Jun Zhou, Department of Pathology, the Second Affiliated Hospital, Shandong University, Jinan 250033, Shandong Province, China
Author contributions: Zuo XL and Li Z contributed equally to this work; Li YQ, Zuo XL and Li Z made substantial contributions to conception and design, drafted the article revised it critically for important intellectual content; Liu XP and Li CQ analyzed data; Ji R, Wang P and Liu H collected, analyzed and interpret patient and endoscopic data; Zhou CJ performed the histopathological analysis; all authors read and approved the final version to be published.
Supported by Grants from Ministry of Health of China (2010); Shandong Province Science and Technology Committee, No. 2007BSB02087; and Graduate Independent Innovation Fund of Shandong University
Correspondence to: Dr. Yan-Qing Li, Professor, Department of Gastroenterology, Qilu Hospital, Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, Shandong Province, China. liyanqing@sdu.edu.cn
Telephone: +86-531-82169236 Fax: +86-531-82169236
Received: June 21, 2011 Revised: December 6, 2011 Accepted: March 10, 2012 Published online: April 21, 2012
Abstract
AIM: To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy (iCLE) and sedation efficacy of propofol vs midazolam plus fentanyl (M/F).
METHODS: Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group (P group) or M/F group. The patient, performing endoscopist and endoscopic assistant were blinded to the randomization. The quality of endomicroscopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.
RESULTS: There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group (72.75% vs 52.89%, P < 0.001). The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group, although this did not reach statistical significance. Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F. Procedure duration and sedation times were significantly longer in the M/F group, while the scores of endoscopist, anesthetist and assistant assessment were all significantly better in the P group.
CONCLUSION: Sedation with propofol might increase the proportion of good quality endomicroscopic images, and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.
