Moderate Sedation with Midazolam and Propofol is As Safe As Propofol Monotherapy for Colonoscopy, but More Cost-Effective

BACKGROUND Moderate sedation can significantly increase the acceptance of preventive colonoscopy, with different sedation regimens being used. AIM To compare sedation with low-dose midazolam in combination with propofol combination therapy (PCT) with sedation with propofol monotherapy (PMT) during preventive colonoscopy. METHODS Retrospective analysis of a total of 120 patients who were sedated with either PCT or PMT. The propofol dose administered, complications such as hypotension or hypoxia, examination time and time to discharge were evaluated. In addition, the costs of the respective sedations were calculated. RESULTS The propofol dose administered was significantly higher in the PMT group than in the PCT group (217 mg vs 65 mg, P < 0.01), the examination time was significantly shorter in the PMT group (18.6 minutes vs 21.4 minutes, P = 0.02) and the time to discharge was significantly shorter in the PCT group (49.4 minutes vs 57.7 minutes, P = 0.04). No patient experienced a sedation-related complication requiring treatment. The costs of sedation in the PCT group were significantly lower than those in the PMT group. CONCLUSION Sedation with midazolam in combination with propofol is as safe for performing outpatient preventive colonoscopy as monotherapy with propofol. Combination therapy may potentially reduce costs.