Application of midazolam combined with propofol on endoscopic retrograde cholangiopancreatography procedure in elder patients

Objective:To observe the sedation and analgesic effects and safety of midazolam with propofol in endoscopic retrograde cholangiopancreatography(ERCP) for elder patients.Methods:Fifty-two elder patients were received midazolam plus propofol for sedation during diagnostic and therapeutic ERCP emergency procedure.The infusion scheme for a target blood propofol concentration of about 3 g/ml,which was according to 10-8-6 programme,consisting of a loading dose of 1 mg/kg of propofol combined with 0.02 mg/kg of midazolam,loading dose over 20 seconds followed immediately by an infusion of 10 mgkg-1h-1 of propofol for 10 minutes;8 mgkg-1h-1 for the next 10 minutes and 6 mgkg-1h-1 thereafter.The observing parameters including systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),SPO2 were recorded on five time points:before infusion,1 minute after infusion,esophagoscope introducing,stop infusion and recovery period.The lasting time on every stage as well as side effects,satisfaction of the procedure were assessed.Results:SBP had no difference on each time point after infusion than before infusion(P0.05).Compared with before infusion,DBP was decreased significantly on the other time points before recovery(P0.05-P0.01).HR and SPO2 were not changed on each time point(P0.05).Anterograde amnesia was appeared in all cases and the total rate of amnesia was 100%.The total rate of patients satisfaction was 98.08%.Conclusions:Midazolam combined with propofol represents a safe and effective sedation technique for elder patients in emergency case of ERCP.