The efficacy and safety of conscious sedation applied with midazolam in the transesophageal echocardiography procedure

Abstract

Abstract Objective The aim of this study was to compare the anaesthesia parameters, procedure duration, and the effect on hemodynamics and clinical parameters during the procedure in patients undergoing transesophageal echocardiography (TEE) with conscious sedation applied with midazolam or propofol. Methods This cross-sectional study included 401 patients (198 males, 203 females, mean age 52.9 ± 14.8 years) applied with TEE in our clinic. The demographic, clinical and laboratory parameters of the patients were recorded before the procedure. A record was made of pre-procedure ASA score and basal SaO2, the time to sedation to TEE, TEE duration, time to recovery, and during the procedure the minimum SaO2, the need for non-invasive mechanical ventilation (NIMV), the change in systolic and diastolic blood pressure (SBP and DBP), O2 saturation change, and pulse change. The data were compared between the patients in two groups according to the conscious sedation agent used; midazolam and propofol. Results The demographic, clinical, and laboratory data of the midazolam and propofol groups were found to be similar (p > 0.05 for each). The procedure duration, and time to recovery were determined to be significantly shorter in the midazolam group than in the propofol group, and the time to onset of the sedation effect was significantly longer (p < 0.05 for each). Of the respiratory parameters, the minimum SaO2 during the procedure, the absolute change in O2 saturation, and the need for NIMV were determined to be significantly lower in the midazolam group (p < 0.05 for each). The absolute pulse and change in SBP and DBP values were found to be significantly higher in the propofol group (p < 0.05 for each). Conclusions The study results demonstrated that conscious sedation applied with midazolam during TEE can be applied with a shorter procedure duration and better hemodynamic and clinical results compared to sedation with propofol.