Gastrointestinal endoscopy is a frequent procedure in the patients with advanced liver disease. It requires variable degree of sedation ranging from minimal sedation to general anesthesia aiming for relieving pain, anxiety, and bad memories of the procedure.

In conscious sedation, patients are able to make purposeful responses to auditory and tactile clues, with maintenance of ventilatory and circulatory stability. while, in deep sedation, patients respond only to painful stimuli, and airway support is frequently required. At the level of general anesthesia, patients are unresponsive, and airway support is mandatory.

The aim of this study is to compare use of propofol or midazolam as sedative for patients with advanced liver disease presented for gastrointestinal endoscopy.

Inclusion Criteria:

• Patients aged between 40 and 60 years old.
• With Child score B or C
• Presented for elective gastrointestinal endoscopy

Exclusion Criteria:

• Emergent condition like hematemesis.
• Patients with moderate to severe hepatic encephalopathy.
• Patients with hepatopulmonary syndrome.
• Patients with known or suspected hypersensitivity to the used medication were also excluded from the study.