Abstract: Objective To compare the safety and sedative effects of different sedative methods of painless gastroscopy. Methods From February 2017 to April 2017，450 patients taken painless gastroscopy in Wuhan No.3 Hospital were randomly divided into three groups，150 patients in group A（propofol），150 patients in group B（propofol combined with midazolam） and 150 patients in group C（propofol combined with remifentanil）. The heart rate，blood pressure，oxygen saturation changes，uncomfortable reaction，wake-up time and operation time were compared in three groups. Results The vital signs of patients in group B and C were more stable than those in group A（P < 0. 05），and the case number of uncomfortable reaction was significantly lower than that in group A（ P < 0. 05）. The dosage of propofol in group B and C was less than that in group A（ P < 0. 05），and the operation time in the three groups was not statistically significant（ P > 0. 05）. The wake-up time was group C < group B< group A（ P < 0. 05）. Conclusion Propofol combined with midazolam or remifentanil is safe and effective in the treatment of painless gastroscopy. Compared with propofol alone，the combination therapy is more beneficial to patients with stable vital signs and less discomfort，it can reduce the dosage of propofol.

Key words: analgesia gastroscopy, sedation, propofol, midazolam, remifentanil