Combined sedation with midazolam/propofol for gastrointestinal endoscopy in elderly patients

<p>Abstract</p> <p>Background</p> <p>Although gastrointestinal endoscopy with sedation is increasingly performed in elderly patients, data on combined sedation with midazolam/propofol are very limited for this age group.</p> <p>Methods</p> <p>We retrospectively analyzed 454 endoscopic procedures in 347 hospitalized patients ≥ 70 years who had received combined sedation with midazolam/propofol. 513 endoscopic procedures in 397 hospitalized patients < 70 years during the observation period served as controls. Characteristics of endoscopic procedures, co-morbidity, complications and mortality were compared.</p> <p>Results</p> <p>Elderly patients had a higher level of co-morbidity and needed lower mean propofol doses for sedation. We observed no major complication and no difference in the number of minor complications. The procedure-associated mortality was 0%; the 28-day mortality was significantly higher in the elderly (2.9% vs. 1.0%).</p> <p>Conclusions</p> <p>In this study on elderly patients with high level co-morbidity, a favourable safety profile was observed for a combined sedation with midazolam/propofol with a higher sensitivity to propofol in the elderly.</p

Propofol intravenous conscious sedation for anxious children in a specialist paediatric dentistry unit

Objectives. To report on both the use and dosage of propofol, as a new intravenous (IV) conscious sedative agent, for anxious children referred to a specialist paediatric dentistry service. Setting. Paediatric Dentistry Unit, Glasgow Dental Hospital and School. Sample. Thirty-four children, 25 females and 9 males, mean age 12 years 10 months, with a mean weight of 54·6 kg (range 30–110 kg). Methods. Report from 34 patients receiving intravenous sedation for the first time in respect of weight dose and amount of treatment completed. Results. Thirty-two children successfully accepted operative dental care on their first visit, they received a mean total dose of 146·25 mg of propofol (range 10 mg to 356 mg); in relation to body weight, the mean was 2·5 mg/kg (range 0·2–5·4 mg/kg). The treatment that they received included fissure sealants, amalgam and adhesive restorations, root canal therapy and single and multiple extractions. Their sedation and recovery were uneventful. Conclusions. Sub-anaesthetic doses of propofol used for IV conscious sedation infusion facilitated operative dental treatment in anxious children