Propofol versus midazolam for procedural sedation in the emergency department: A study on efficacy and safety

Current status of perioperative hypnotics, role of benzodiazepines, and the case for remimazolam: a narrative review

“…In a UK snapshot survey of 360 patients sedated in six hospitals, the most frequent sedative combination was midazolam and fentanyl with median doses of fentanyl 50 mg and midazolam 2 mg. 83 Importantly, apnoea and airway obstruction are less common with midazolam than with propofol. 117 In volunteers given remimazolam, 109 respiration was maintained, and only two episodes of desaturation were noted and both managed with simple measures. In studies of remimazolam sedation for colonoscopy, 110 upper endoscopy, 111 and bronchoscopy, 112 there were few episodes of respiratory depression or hypoxaemia, and the incidence was similar to or less than with midazolam.…”

Use of advanced intravenous conscious sedation techniques in complex oral surgery procedures: Comparison of midazolam, midazolam‐propofol and midazolam‐propofol‐alfentanil combinations

“…Blayney et al 2003 33 investigated target-controlled infusions (TCI) of propofol in dental procedures and reported an adverse event rate of nearly 10%. The target concentration of propofol was high at 2.1ug/ml, nearly three times greater than 34 showed that propofol had a greater procedural success than midazolam (92% vs. 81%). Propofol also had a faster recovery time; however, within the propofol group, there was a higher respiratory adverse event rate of 18.9% compared to 10% in the midazolam sedated group again; this was using a very high dose of propofol (median dose of 75 mg, N = 284 patients).…”

“…They concluded that propofol does not demonstrate the margin of safety required to satisfy the General Dental Council definition of a sedative agent suitable for use by dentists. Another comparison of the use of propofol and midazolam for use of conscious sedation in an emergency department in the Netherlands by Lemeijer et al 2017 34 showed that propofol had a greater procedural success than midazolam (92% vs. 81%). Propofol also had a faster recovery time; however, within the propofol group, there was a higher respiratory adverse event rate of 18.9% compared to 10% in the midazolam sedated group again; this was using a very high dose of propofol (median dose of 75 mg, N = 284 patients).…”

Sedation With a Combination of Dexmedetomidine and Midazolam for Pediatric Dental Surgery

“…Propofol (PRO) and midazolam (MDZ) are popular sedatives for IVS for dental patients. A previous study reported that PRO is more effective and at least as safe as MDZ for intravenous procedural sedation in emergency medicine 1 and also in dental treatment. Although PRO is likely to be safe in the vast majority of children with egg-related allergies, some anesthesiologists suggest that it should not be administered to these children, 2 and some case reports have supported this recommendation.…”