Efficacy and safety of etomidate-midazolam for screening colonoscopy in the elderly

Jung Min Lee, Geeho Min, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim, Jong Jae Park, Beom Jae Lee, Seong Ji Choi, Woojung Kim

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background and aims: Recent studies have shown that etomidate is associated with fewer serious adverse events than propofol and has a noninferior sedative effect. We investigated whether etomidate-midazolam is associated with fewer cardiopulmonary adverse events and has noninferior efficacy compared to propofol-midazolam for screening colonoscopy in the elderly. Methods: A prospective, single-center, double-blinded, randomized controlled trial was performed. Patients aged over 65 years who were scheduled to undergo screening colonoscopy were randomized to receive either etomidate or propofol based on midazolam. The primary outcome was all cardiopulmonary adverse events. The secondary outcomes were vital sign fluctuation (VSF), adverse events disturbing the procedure, and sedation-related outcomes. Results: The incidence of cardiopulmonary adverse events was higher in the propofol group (72.6%) than in the etomidate group (54.8%) (P=.040). VSF was detected in 17 (27.4%) and 31 (50.0%) patients in the etomidate and propofol groups, respectively (P=.010). The incidence rate of adverse events disturbing the procedure was significantly higher in the etomidate group (25.8%) than in the propofol group (8.1%) (P=.008). Moreover, the incidence rate of myoclonus was significantly higher in the etomidate group (16.1%) than in the propofol group (1.6%) (P=.004). There was no statistical significance between the 2 groups with respect to sedation times and sedation-related outcomes including patients' and endoscopist's satisfaction. In the multivariate analysis, the etomidate group had significantly low odds ratio (OR) associated with VSF (OR: 0.407, confidence interval: 0.179-0.926, P=.032). Conclusions: We recommend using etomidate-midazolam in patients with high ASA score or vulnerable to risk factors; propofol-midazolam may be used as a guideline in patients with low ASA score.

Original languageEnglish
Article numbere10635
JournalMedicine (United States)
Issue number20
Publication statusPublished - 2018 May 1

Bibliographical note

Funding Information:
This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2017R1C1B5076677) and by Korea University.

Publisher Copyright:
© 2018 the Author(s).


  • colonoscopy
  • elderly
  • etomidate
  • midazolam
  • sedation

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Efficacy and safety of etomidate-midazolam for screening colonoscopy in the elderly'. Together they form a unique fingerprint.

Cite this