Nursing use between 2 methods of procedural sedation: Midazolam versus propofol

We compared propofol (P) and midazolam (M) use in sedation using nurses' (RN's) monitoring times, costs, and visual analog scale (VAS) satisfaction scores. We randomized 40 patients to either P or M groups. The P group received 0.5 mg/kg IV followed by titration to a Ramsay Sedation Scale of 3 or 4. The M group received 1 mg IV every 2 minutes to a Ramsay Sedation Scale of 3 or 4. Time for sedation, procedure, and recovery were compared. VAS scores were measured for the patient, RN, and physician. Thirty-two patients completed the study. Median RN monitoring time was 52 minutes for the M group and 36 minutes for the P group. VAS score differences were significant only in the physician group. We concluded that compared with midazolam, propofol required less RN monitoring and had lower costs. Physician satisfaction was higher with propofol sedation than with midazolam and required less time.