Table 4

Author, date and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Gupta A et al, 1990, Sweden30 patients undergoing cardioversionPRCTPhysiological observationsDecreased 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 timesShorter 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, USA90 patients undergoing central venous line insertionPRCTPhysiological observationsNo 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)ComplicationsApnoea in 3 of PB group, none required assisted ventilation
Recovery timeRecovery time shorter with propofol, 8 min (PI) and 14 min (PB) v 25 min with midazolam (p<0.05)
Parworth LP et al, 1998, USA57 patients undergoing 3rd molar tooth extraction.PRCTPhysiological observations2 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 propofolUnblinded. Recovery time not assessed.
Sedation efficiencyPropofol group less cooperative (p=0.02).
Havel CJ Jr et al, 1999, USA89 children aged 2–18 with isolated limb injury requiring reduction in EDPRCTRecovery timeRecovery 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 propofolComplicationsNo differences in rates of hypoxia, hypotension. No clinically significant complications.Incomplete follow up after discharge
Sedation scoresSedation scores equivalent between groups.