Perbandingan Keamanan Midazolam dan Propofol sebagai Agen Sedasi pada Prosedur Medis
DOI:
https://doi.org/10.59680/anestesi.v4i2.2348Keywords:
Midazolam, Medical Procedures, Propofol, Sedation Safety, Systematic ReviewAbstract
Procedural sedation is used to enhance patient comfort and the success of medical procedures. Midazolam and propofol are the most commonly used sedative agents, each with a distinct safety profile. The objective of this study is to compare the safety profiles of midazolam and propofol in the context of medical procedures. This study employs a systematic literature review approach based on the PRISMA guidelines. The literature search was conducted via PubMed, ScienceDirect, and Google Scholar from 2015 to 2025. The analyzed articles included randomized controlled trials (RCTs) and cohort studies. Methodological quality assessment was performed using an instrument from the Joanna Briggs Institute (JBI). A total of 16 studies involving more than 1,000 patients were analyzed. Propofol demonstrated a higher procedure success rate (90.9%) compared to midazolam (83.3%). However, propofol was associated with a higher risk of hypotension (31.5%) and bradycardia (17.1%). On the other hand, midazolam was more hemodynamically stable but had a longer duration of sedation. Propofol is superior in achieving procedural success but carries a higher risk of hemodynamic disturbances. Midazolam demonstrates better stability but is less superior in terms of sedation effectiveness and carries a higher risk of neurological complications and mortality.
References
Abdulamir, A. N., Hospital, A. T., & Authority, K. H. (2025). Comparison between propofol and midazolam infusion on cardiovascular stability in critically ill patient. International Journal Of Medical ScienceS, 8(May), 27–38.
Afghaniyan, P., Farhadian, M., Tarbiat, M., Bakhshaei, M. H., & Salimbahrami, S. A. (2024). Comparing the hemodynamic effects of midazolam, etomidate, and propofol following anesthesia induction in coronary artery bypass graft surgery: A double-blind randomized clinical trial. Journal of Tehran University Heart Center, 19(2), 89–95. https://publish.kne-publishing.com/index.php/JTHC/article/view/16197
Al-Shareef, A. S., Babkair, K., Baljoon, J. M., Alkhamisi, T. A., Altwairqi, A., Bogari, H., & others. (2024). Propofol vs. midazolam as the initial sedation strategy for mechanically ventilated patients: A single-center experience from Saudi Arabia. Cureus, 16(8), 1–8.
Apfelbaum, J. L., Gross, J. B., Connis, R. T., Agarkar, M., Arnold, D. E., Coté, C. J., & others. (2018). Practice guidelines for moderate procedural sedation and analgesia 2018. Anesthesiology, 128, 437–479.
Flores-Pérez, C., Moreno-Rocha, L. A., Chávez-Pacheco, J. L., Noguez-Méndez, N. A., Flores-Pérez, J., Ortiz-Marmolejo, D., & others. (2023). Pharmacokinetic–pharmacodynamic modeling of midazolam in pediatric surgery. Pharmaceutics, 15(11), 1–16.
Gelder, T. G., van Diem-Zaal, I. J., Dijkstra-Kersten, S. M. A., de Mul, N., Lalmohamed, A., & Slooter, A. J. C. (2024). The risk of delirium after sedation with propofol or midazolam in intensive care unit patients. British Journal of Clinical Pharmacology, 90(6), 1471–1479. https://doi.org/10.1111/bcp.16031
Green, S. M., Irwin, M. G., Mason, K. P., Absalom, A., Alcaino, E., Andolfatto, G., & others. (2021). Procedural sedation: Providing the missing definition. Anaesthesia, 76(5), 598–601.
Julián Gómez, L., Fuentes Coronel, A., López Ramos, C., Ochoa Sangrador, C., Fradejas Salazar, P., Martín Garrido, E., Conde Gacho, P., Bailador Andrés, C., García-Alvarado, M., Rascarachi, G., Castillo Trujillo, R., & Rodríguez Gómez, S. J. (2018). A clinical trial comparing propofol versus propofol plus midazolam in diagnostic endoscopy of patients with a low anesthetic risk. Revista Española de Enfermedades Digestivas, 110(11), 691–698. https://doi.org/10.17235/reed.2018.5289/2017
Kikuchi, H., Hikichi, T., Watanabe, K., Nakamura, J., Takagi, T., Suzuki, R., & others. (2018). Efficacy and safety of sedation during endoscopic submucosal dissection of gastric cancers using a comparative trial of propofol versus midazolam. Unknown Journal, 51, 51–57.
Lameijer, H., Sikkema, Y. T., Pol, A., Bosch, M. G. E., Beije, F., Feenstra, R., & others. (2017). Propofol versus midazolam for procedural sedation in the emergency department: A study on efficacy and safety. American Journal of Emergency Medicine, 35(5), 692–696. https://doi.org/10.1016/j.ajem.2016.12.075
Lin, I.-H., Huang, M.-S., Wang, P.-Y., Huang, T.-S., Chong, S.-Y., Chen, S. L.-S., & Tsai, H.-H. (2021). A comparative study of propofol alone and propofol combined with midazolam for dental treatments in special needs patients. Medicine, 100(22), e26199. https://doi.org/10.1097/MD.0000000000026199
Offord, D. J., Kingsford, N. M., Paterson, R., Mather, C. I., & Robb, N. D. (2022). Use of advanced intravenous conscious sedation techniques in complex oral surgery procedures: Comparison of midazolam, midazolam-propofol and midazolam-propofol-alfentanil combinations. Oral Surgery, 15(3), 242–250.
Rana, M. A., Shafiq, T., H., Akram, M. A., & Nisar, A. (2022). Comparison of mean time required to achieve sedation in patients undergoing surgery in spinal anaesthesia treated with propofol vs. midazolam. Pakistan Journal of Medical & Health Sciences, 16(3), 273–275.
Rocco, M., Maggi, L., Ranieri, G., Ferrari, G., Gregoretti, C., Conti, G., & others. (2017). Propofol sedation reduces diaphragm activity in spontaneously breathing patients: Ultrasound assessment. Minerva Anestesiologica, 83(3), 266–273.
Sahinovic, M. M., Struys, M. M. R. F., & Absalom, A. R. (2018). Clinical pharmacokinetics and pharmacodynamics of propofol. Clinical Pharmacokinetics, 57(12), 1539–1558. https://doi.org/10.1007/s40262-018-0672-3
Trial, C., Study, E., Song, H. Y., Shen, L. J., Sun, W., Zhang, L. D., & others. (2024). Comparison of patient-controlled analgesia and sedation (PCAS) with remifentanil and propofol versus total intravenous anesthesia (TIVA) with midazolam, fentanyl, and propofol for colonoscopy. INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, April 2023, 1–7. https://doi.org/https://doi.org/10.32441.ijms.8.2.3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jurnal Anestesi

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.













