Gupta A et al, 1990, Sweden | 30 patients undergoing cardioversion | PRCT | Physiological observations | Decreased BP in propofol group, equal incidences of desaturation. Apnoea requiring assisted ventilation in 3 of propofol group. | Not emergency setting |
| | | | | Unblinded |
| Randomised to midazolam or propofol or thiopentone | | | | |
| | | Sedation and recovery times | Shorter time to sedation and to recovery with propofol v midazolam (p<0.05). | Sedation titrated to loss of eyelash reflex (that is, not conscious sedation) |
Pratila MG et al, 1993, USA | 90 patients undergoing central venous line insertion | PRCT | Physiological observations | No significant cardiovascular adverse events. Sao2 drop 2.2% with propofol (PB) v 0.3% midazolam (p<0.04) | Not emergency setting |
| | | | | Unblinded |
|
Randomised midazolam or propofol boluses (PB) or infusion (PI) | | Complications | Apnoea in 3 of PB group, none required assisted ventilation | |
| | | Recovery time | Recovery time shorter with propofol, 8 min (PI) and 14 min (PB) v 25 min with midazolam (p<0.05) | |
Parworth LP et al, 1998, USA | 57 patients undergoing 3rd molar tooth extraction. | PRCT | Physiological observations | 2 in midazolam group v 1 in propofol group were apnoeic for >20 secs, none required assisted ventilation. No significant cardiovascular adverse events. | All patients given fentanyl. |
Not emergency setting. |
Randomised to midazolam or propofol | Unblinded. Recovery time not assessed. |
Sedation efficiency | Propofol group less cooperative (p=0.02). |
Havel CJ Jr et al, 1999, USA | 89 children aged 2–18 with isolated limb injury requiring reduction in ED | PRCT | Recovery time | Recovery in 14.9 min with propofol v 76.4 min with midazolam (p<0.001) | All patients given morphine. |
Small numbers to detect significant complications. |
| Randomised to midazolam or propofol | | Complications | No differences in rates of hypoxia, hypotension. No clinically significant complications. | Incomplete follow up after discharge |
| | | Sedation scores | Sedation scores equivalent between groups. |