Hemodynamics in elderly coronary artery disease patients undergoing propofol sedation.
OBJECTIVE
The purpose of this study was to evaluate noninvasive intraoperative hemodynamics in an elderly population with coronary artery disease (CAD) undergoing midazolam/fentanyl intravenous sedation-analgesia, with or without propofol for dentoalveolar surgery.


METHODS
A retrospective chart analysis of 24 consecutive male patients aged 60 years or greater, with coronary artery disease, undergoing midazolam/fentanyl intravenous sedation-analgesia with or without propofol for dentoalveolar surgery. Data recorded included 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), and pulse (P).


RESULTS
The addition of propofol to elderly CAD patients resulted in statistically significant lower averages for SBP (126.1 mm Hg vs 131.3 mm Hg, P < .01), DBP (64.1 mm Hg vs 74.3 mm Hg, P < .001), MAP (84.3 mm Hg vs 94.2 mm Hg, P < .001) and PP (57.7 mm Hg vs 61.8 mm Hg, P = .01) with statistically insignificant differences in pulse (74.2 beats per minute vs 75.8 beats per minute, P = .1). Baseline changes in elderly CAD patients who received propofol were within +/-20% (range: -13.8% to +6.9%).


CONCLUSIONS
Midazolam/fentanyl intravenous sedation provided stable intraoperative hemodynamics in elderly CAD patients. The addition of propofol to elderly CAD patients also resulted in stable intraoperative hemodynamics and may be a safe adjunct to intravenous sedation in elderly CAD patients.
Cillo
Joseph E
JE
Department of Oral and Maxillofacial Surgery, The University of Texas Southwestern Medical Center/Parkland Memorial Hospital, Dallas, TX, USA. jecdna@aol.com
Finn
Richard
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000766:Anesthesia, Dental; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D016292:Procedural Sedation; D003327:Coronary Disease / Q000503:physiopathology*; D005283:Fentanyl / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007430:Intraoperative Care; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D019647:Oral Surgical Procedures; D015742:Propofol / Q000008:administration & dosage*; D011674:Pulse; D012189:Retrospective Studies; D012449:Safety
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol