| The Comparison of Sedation Quality, Side Effects, and Recovery Profiles of Propofol Alone, Propofol-Fentanyl and Porpofol-Ketamine PCS for MAC. |
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Jin Woo Choi, Jin Deok Joo, Jang Hyeok In, Yong Shin Kim, Yeon Su Jeon, Keon Hee Ryu, Dae Woo Kim, Hyen Tac Lee |
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Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. VINCNT@chol.com |
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| Abstract |
BACKGROUND
Propofol has been the most widely used IV adjuvant during Monitored anesthesia care (MAC), even though it lacksanalgesic properties. This study was designed to compare sedation quality, side effects, and recovery profiles of propofol alone (group P), propofol-fentanyl (group PF) and propofol-ketamine (group PK) using PCS for breast biopsy procedures using local anesthesia.
METHODS
Anxiety VAS, pain VAS and digit symbol substitution test (DSST) were measured in 60 excision breast biopsy patients with local anesthesia. Vital signs, respiratory (SpO2, RR, and ETCO2) variables, BIS, and OAA/S scores were recorded. Perioperative side effects (e. g., pain on injection, excessive sedation [OAA/S < 4], hypoventilation [ventilatory frequency 8 bpm], hypotension, dizziness, unpleasant feeling, Nausea) were also noted.
RESULTS
There were no differences among the three PCS groups with respect to demographic data (Table 1). A/D ratio in PK group had a significant increase over P group. The incidence of excessive sedation and dizziness were significantly more frequent in the PK group patients (P < 0.05)(Table 1, 2). OAA/S scores were significantly decreased in the PK group during near the end of surgery, whereas BIS scores were only at the end of surgery (P < 0.05)(Fig. 1, 2). During 15 min after arrival at recovery room, significantly less patients in the PK group gave correct responses on the DSST than other groups (P < 0.05)(Fig. 2, 3).
CONCLUSIONS
In contrast to past studies of ketamine as an alternative to opioid adjuncts during propofol PCS, it has no more advantage than supplemental fentanyl in terms of sedation level and side effects. |
| Key Words:
monitored anesthesia care (MAC); patient-controlled sedation (PCS) |
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