Thirty-six studies (n=3,918) with 75 treatment arms were included in the review. Of these, 23 studies scored 3 or less on the Jadad scale, which was taken to indicate lower quality.
Sedation improved patient satisfaction (RR 2.29, 95% CI: 1.16, 4.53) and willingness to repeat esphagogastroduodenoscopy (RR 1.25, 95% CI: 1.13, 1.38) compared with no sedation. Midazolam had higher patient satisfaction (RR 1.18, 95% CI: 1.07, 1.29) and willingness to repeat procedure (RR 1.08, 95% CI: 1.04, 1.13), and less memory of the examination (RR 0.57, 95% CI: 0.50, 0.60) than diazepam. Midazolam plus narcotic had lower patient satisfaction than propofol (RR 0.90, 95% CI: 0.83, 0.97). There were no other significant differences in efficacy. Recovery times were statistically significantly shorter in groups treated with propofol containing regimes in five of the six RCTs that reported this outcome. Results of the assessments of heterogeneity were not fully reported.