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World J Gastrointest Endosc. Apr 16, 2026; 18(4): 118261
Published online Apr 16, 2026. doi: 10.4253/wjge.v18.i4.118261
Published online Apr 16, 2026. doi: 10.4253/wjge.v18.i4.118261
Moderate sedation with midazolam and propofol is as safe as propofol monotherapy for colonoscopy, but more cost-effective
Claudia Ott, Philipp Dobsch, Markus Sander, Internal Medicine and Gastroenterology, Gastroenterology at FAZ, Regensburg 93053, Bavaria, Germany
Elisabeth Schnoy, Medical Clinic III, University of Augsburg, Augsburg 86156, Bavaria, Germany
Michael T Pawlik, Department of Anesthesiology and Intensive Care Medicine, Caritas Hospital St. Josef, Regensburg 93053, Bavaria, Germany
Author contributions: Ott C designed the study; Ott C and Pawlik MT were responsible for developing the methodology; Dobsch P and Sander M participated in the formal analysis and investigation; Ott C wrote the original draft; Dobsch P, Sander M, Schnoy E and Pawlik MT participated in the review and editing.
Institutional review board statement: A vote was obtained and approved by the Regensburg Ethics Committee under No. 25-4430-104.
Informed consent statement: All patients gave informed consent in data storage and analysis.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: No data sharing.
Corresponding author: Claudia Ott, MD, PhD, Internal Medicine and Gastroenterology, Gastroenterology at FAZ, Hildegard-von-Bingen-Str. 1, Regensburg 93053, Bavaria, Germany. claudiaott4@t-online.de
Received: December 29, 2025
Revised: February 5, 2026
Accepted: March 13, 2026
Published online: April 16, 2026
Processing time: 106 Days and 15.3 Hours
Revised: February 5, 2026
Accepted: March 13, 2026
Published online: April 16, 2026
Processing time: 106 Days and 15.3 Hours
Core Tip
Core Tip: Various guideline recommendations for sedation in gastroenterological endoscopy exist, but there is little data available on the use of combination therapy with low-dose midazolam in combination with propofol vs propofol monotherapy (PMT) for short-term outpatient procedures in patients with a low examination risk. This cohort study analysed the safety and costs of a combination therapy with low-dose midazolam in combination with propofol vs PMT in 120 patients undergoing preventive colonoscopy. Combination therapy was as safe as PMT, but was less expensive.