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.
Cillo
Joseph E
JE
Oral and Maxillofacial Surgery, parkland Memorial Hospital, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Finn
Richard
R
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