Comparitive Evaluation of Propofol and Midazolam as Conscious Sedatives in Minor Oral Surgery

Abstract

Objective The objective of the study was to assess the efficacy of propofol and midazolam as an intravenous sedative agent in minor oral surgical procedures in terms of: (a) the onset of action, (b) heart rate, (c) oxygen saturation, (d) systolic and diastolic blood pressure, (e) respiratory rate, (f) pain during the injection of sedative agent, (g) recovery period, (h) side effects, (i) patient's cooperation during the surgery. Methodology This was a double blind randomized study in which one group of 20 patients received propofol with the induction dose of 0.5 mg/kg and 50 lg/kg/min which was administered by syringe infusion pump as a maintenance dose and the other group received midazolam in a single dose of 75 lg/kg and no maintenance dose was given, instead 5 % dextrose was administered by syringe infusion pump at the rate of 50 lg/kg/min. Since propofol was milky white in colour, a green cloth was covered over the infusion pump in all cases. The surgeon, assistants and observers were blind about the medications which would be given to the patient for sedation. After the administration of the sedative, local anesthesia was achieved with 2 % lignocaine hydrochloride. Results The onset of action in propofol group was significant as onset of action was faster. The maximum increase in heart rate in propofol group was at 10 min intraoperatively (Mean ± 80.40 ± 12.73) and that in midazolam group was at 15 min intraoperatively (Mean 79.25 ± 13.44). Post operatively the heart rate decreased near to the baseline value in both the groups. The average oxygen saturation before induction in propofol group was 99.7 ± 0.73 % and that of midazolam group was 99.15 ± 01.31 P = 0.314. None of the patients in this study developed apnea. The systolic blood pressure (Mean ± SD) before induction in both the groups decreased from the baseline value after the administration of sedatives. The diastolic blood pressure (Mean ± SD) before induction in both the groups decreased from the baseline value after the administration of sedatives and the decreased diastolic blood pressure was maintained throughout the procedure. The respiratory rate (Mean ± SD) before induction in both the groups decreased from the baseline value after the administration of sedatives. The decreased respiratory rate remained throughout the surgical procedure. Pain during the injection of the sedatives was reported by nine patients (45 %) in the propofol group whereas none of the patients in midazolam group complained of pain during the injection. This is statistically significant (P = 0.001). The recovery time (Mean ± SD) in propofol group was 22.50 ± 3.04 (range 15-25 min) and that in midazolam group was 33.75 ± 3.93 (range 30-40 min), which was statistically significant (P \ 0.001). Patients in the propofol group were significantly less co-operative than midazolam group at both 10 and 25 min intra operatively. Conclusion The design of the present study permitted qualitative assessment of propofol and midazolam as sedative agents in minor oral surgical ...

Propofol with and without Midazolam for Diagnostic Upper Gastrointestinal Endoscopies in Children

“…Midazolam increased the inhibitory effect of gamma-aminobutyric acid by binding between the alpha and gamma subunits present on the acid receptors [25]. Intravenous midazolam may cause respiratory depression due to direct suppression of the central respiratory drive, rather than as a result of simultaneous depression of the respiration muscles [26].…”

Propofol attenuates mast cell degranulation via inhibiting the miR‑221/PI3K/Akt/Ca2+ pathway

“…Propofol is a widely used intravenous anesthetic agent with rapid onset, short duration of action and rapid elimination (7). A number of pharmacological characteristics of propofol have been reported, including antipruritic, anti-convulsant, anti-oxidant and anti-inflammatory activities (8).…”

Effects of intravenous administration of propofol and midazolam on pentylenetetrazole kindled seizures in rats

“…It has been reported that propofol has a rapid on-rapid-off action with a short half-life of 20 minutes (Kotegawa et al, 2002). By contrast, midazolam have a longer duration of action compared to that of propofol, and a longer half-life of 49 min (Greenblatt et al, 2000;Hari Keerthy et al, 2015). In addition, the lower potency of propofol against PTZ kindled seizures could have been related to the rapid-on rapid-off action at GABAA receptors.…”