Comparison of sedative effect of midazolam and propofol in patients with renal failure

Peritoneal dialysis (PD) is a form of dialysis which is used mostly in children. Insertion of PD devices catheter needs a sedation and midazolam and fentanyl usually are used for this purpose. In some studies propofol also used as a sedative in renal failure patients, hospitalized in intensive care units (ICU). No study has been conducted so far on comparison of midazolam with propofol in patients. Therefore, this study was aimed to compare the sedative effect of midazolam and propofol in the patients with renal failure, used PD device. In this clinical trial study, a total of 44 patients aged ranged 18-65 years, with physical condition of class III and IV (based on ASA classification) and with chronic renal failure who needed peritoneal dialysis catheter were randomly designated into two groups of 22 individuals. The first group was injected with propofol (50 mg/kg) and fentanyl and the second one with midazolam (50 mg/kg) and fentanyl. Then, using Ramsay score, sedation score and vital markers, before and after the intervention, were evaluated. The required clinical symptoms were obtained using an appropriate questionnaire and using Man-Whitney and t test, the data were analyzed. According to the results of this study propofol induced a higher sedation level than that of midazolam (P<0.001). There was no significant difference in O2 saturation between the two groups. Blood pressure and pulse rate in the group received propofol were (P<0.001) decreased whereas in the group received midazolam were increased (P<0.05). The mean of pain, based on visual analog scale (VAS), in the groups received propofol and midazolam was 2.68±0.49 and 3.64±0.4, respectively (P<0.05). Durations of recovery in the groups received propofol and midazolam were 25.86±2.98 and 31.68±3.12, respectively (P<0.01). Based on the results, the patients received propofol had more relief and less pain than those received midazolam. Thus, propofol is suggested to be used in the patients with renal failure who need PD catheterization.