Moderate intravenous sedation for office-based full face laser resurfacing using a continuous infusion propofol pump.
OBJECTIVE
The purpose of this study was to compare the anesthetic requirements and hemodynamic and oxygenation variables involved between the bolus midazolam/fentanyl intravenous sedation-analgesia technique, and the same technique combined with continuous-infusion propofol.


METHODS
This was a retrospective chart analysis of 41 consecutive patients undergoing full-face carbon dioxide laser resurfacing with either bolus midazolam/fentanyl (n = 15) or midazolam/fentanyl with continuous propofol infusion anesthesia (n = 26) techniques. Data recorded were noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), pulse (P), and rate-pressure product (RPP), respiratory rate (RR), and oxygen saturation (SpO2). Data collected were reported as mean values with standard deviation. Statistical analyses were performed with the Student's t test and found statistically significant for P < .05.


RESULTS
Statistically significant decreases in averages were seen in SBP (P < .001), DBP (P = .02), MAP (P = .004), P (P < .00l), RPP (P < .00l), and RR (P < .001), but not PP (P = .4) and SpO2 (P = .08) in the midazolam/fentanyl/continuous propofol infusion group compared with the midazolam/fentanyl only group. Changes from baseline were statistically significant only for MAP (P = .04), but statistically insignificant for all other measurements, SBP (P = .7), DBP (P = .4), P (P = .95), PP (P = .97), RPP (P = .6), RR (P = .6), and SpO2 (P = .4). Statistically significant smaller amounts of midazolam (P = .01) and fentanyl (P < .001) were used in the midazolam/fentanyl/continuous propofol infusion pump group. Length of procedure was statistically insignificant between groups (P = .4). Conclusion The addition of a continuous propofol pump maintained hemodynamic and oxygenation values close to baseline, while decreasing the amount of respiratory depressing opiates administered and without affecting the length of the procedure.
Oral and Maxillofacial Surgery, parkland Memorial Hospital, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Joseph E
JE
Cillo
Richard
R
Finn
D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000766:Anesthesia, Dental / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000295:instrumentation; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide; D016292:Procedural Sedation / Q000379:methods*; D005148:Facial Dermatoses / Q000209:etiology / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007260:Infusion Pumps; D007642:Keratosis / Q000209:etiology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D013472:Sunlight / Q000009:adverse effects
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D002245:Carbon Dioxide; D010100:Oxygen; D015742:Propofol