Publication: Propofol Sedation During Spinal Anaesthesia - A Dose Finding Study
Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
It is important to be able to measure and maintain a specific sedation level to
compare outcomes of different levels of sedation during anesthesia and the aims
include general patient comfort, freedom from specific discomfort, and some
amnesia for both the block procedure and the surgical operation, in order to meet
the patient’s preference and safety. In this prospective randomized clinical study,
we compared the three different infusion doses of propofol.
Objective
To find out the appropriate infusion dose of propofol for optimal sedation without
causing undue side effects in patients undergoing spinal anaesthesia.
Method
One hundred twenty patients ASA PS I-II were randomly allocated to three groups
1, 2 and 3 receiving propofol infusion at the rate of 25, 50 and 75 microgram/kg/
min with concentration of (0.5%), (1%) and (1.5%) respectively. They were observed
for sedation score, hemodynamic parameters and satisfaction level. The adverse
effects like respiratory depression, nausea and vomiting score were assessed.
Result
Median sedation score increased in a dose dependent manner, with significantly
higher scores in group 2 and 3 compared with group 1. Hemodynamic parameters
were better in group 1 and 2 as judged by mephentermine requirement. The
awakening time after stoppage of infusion was significantly delayed in group 3 (p
< 0.001). Respiratory depression, nausea and vomiting were comparable clinically.
Almost three fourth of the patients were satisfied with the techniques used.
Conclusion
Propofol infusion at the rate of 50mcg/kg/min for sedation in spinal anaesthesia
provides optimal sedation, early awakening and excellent satisfaction level in the
postoperative period
KEYWORDS
propofol, sedation, spinal anaesthesia.
Description
Ghimire A,1 Bhattarai B,1 Rahman TR,1 Singh SN,1 Koirala S,1 Tripathi M2
1 Department of Anaesthesiology and Critical care, BPKIHS, Dharan, Nepal.
2Department of Anaesthesiology and Critical care, SGPGIMS, Lucknow, India