Propofol deep sedation with and without midazolam for percutaneous radiofrequency ablation in patients with hepatocellular carcinoma: A retrospective cohort study

Objective: The study is aimed to evaluate and compare clinical efficacy of propofol deep sedation [PDS] with and without midazolam for percutaneous radiofrequency ablation [RFA] in adult patients with hepatocellular carcinoma in a radiology unit of a teaching hospital, Thailand. Materials and Methods: The authors undertook a retrospective review of RFA procedures. Patients were classified into two groups: group P (PDS without midazolam) and group PM (PDS with midazolam). The primary outcome variable of the study was the successful completion of procedure. Secondary outcome variable was sedation-related complication during and immediately after the procedure. Results: After matching patients’ characteristics and duration of procedure, there were 65 patients in group P and 194 patients in group PM. There were no significant differences in characteristics of patients, duration of procedure and preprocedural problems between the two groups. All procedures were successfully completed. There were no significant differences in overall complication rate and hemodynamic parameters including systolic and diastolic blood pressure, heart rate and oxygen saturation between the two groups. However, hypotension and bradycardia in group P was relatively greater than in group PM. Conclusion: PDS with and without midazolam for RFA in patients with hepatocellular carcinoma with appropriate monitoring is relatively safe and effective. Clinical efficacy of PDS with midazolam for this procedure is not different or greater than in PDS without midazolam. No serious complication is noted.