The Effect of the Level of Sedation on Recovery in Patients undergoing Target Controlled Propofol Infusion with a Bolus of Fentanyl for Strabismus Surgery.

Chang,  Hae Wone; Ryu,  Keon Hee; Lee,  Yoon ki; Park,  Chong Min; Park,  Sang Yong

doi:2007.52.6.S42

Randomized Controlled Trial

Korean Journal of Anesthesiology 2007;52(6):S42-S46.
DOI: https://doi.org/10.4097/kjae.2007.52.6.S42

The Effect of the Level of Sedation on Recovery in Patients undergoing Target Controlled Propofol Infusion with a Bolus of Fentanyl for Strabismus Surgery.

Hae Wone Chang, Keon Hee Ryu, Yoon ki Lee, Chong Min Park, Sang Yong Park

¹Department of Anesthesiology and Pain Medicine, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. ryu4912@naver.com
²Cheongju St. Mary's Hospital, Cheongju, Korea.

Abstract

BACKGROUND
An immediate examination of ocular movement is required during strabismus surgery. The aim of this study was to determine the effect of the level of sedation on the recovery of patients undergoing a target controlled propofol infusion with a bolus of fentanyl for strabismus surgery.
METHODS
Twenty-one outpatients scheduled to undergo strabismus surgery were assigned randomly to one of two groups. In both groups, sedation was induced with a bolus of fentanyl 1microgram/kg intravenously followed by an infusion of propofol with a target concentration of 1.0microgram/ml. The target concentration was increased or decreased by 0.1 microgram/ml steps until the patient reached and maintained the observer's assessment of alertness/sedation (OAA/S) scale score of 3 (group A) or 4 (group B). The supplemental analgesics consisted of fentanyl 25-50microgram bolus injection. The target concentration of propofol, the total dose of fentanyl, delayed awakening, and recovery time were recorded. RESULTS: The mean target concentration of propofol (mean +/- SD) in group A (1.8 +/- 0.4microgram/ml) was significantly higher than that of group B (1.3 +/- 0.4microgram/ml) (P<0.05). There were no significant differences in the total dose of fentanyl, delayed awakening and recovery time between the two groups. There was an an increasing trend in the recovery time with the total dose per kilogram of body weight of fentanyl (Spearman's correlation coefficient, r = 0.384, P = 0.086). CONCLUSIONS: The levels of sedation did not affect the recovery time in patients during target propofol infusion with a bolus of fentanyl. However, the addition of fentanyl tended to prolong the recovery time.

Key Words: strabismus surgery; sedation; recovery; propofol; fentanyl