title: [Application of conscious sedation with midazolam, propofol and sufentanil for patients in plastic surgery].
abstract: OBJECTIVE
  To observe the effectiveness of conscious sedation with midazolam, propofol and sufentanil for patients in plastic surgery.
  
  
  METHODS
  81 patients, scheduled for plastic surgery, were randomly selected to receive conscious sedation with midazolam 0.05 mg x kg(-1) and sufentanil 0.1 microg x kg(-1) intravenously, following by a continuous infusion of midazolam-propofol-sufentanil combination (midazolam 5 mg + propofol 200 mg + sufentanil 10 microg, a total of 23 ml). The initial infusion rate was 0.2 ml x kg(-1) x h(-1), and was adjusted (in 20% of initial infusion rate increment) to maintain OAA/S score as 11 during the operation. The patients' vital signs, discomfort and level of sedation were evaluated at 5 to 10 min intervals until the end of the surgery. The complications (i. e. anoxemia, apnea, restlessness, nausea and vomiting), anesthesia duration and drug consumption were recorded. The drug infusion was discontinued at 5 - 10 min before the end of the surgical procedure. On the first postoperative day, patients were asked to rate their satisfaction with the anesthetic management and whether they would choose to receive the same anesthetic technique if necessary in the future.
  
  
  RESULTS
  The OAA/S score decreased from 20.0 +/- 0 to 11.9 +/- 2.6 after midazolam and sufentanil IV (P < 0.05), and was maintained as 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score returned to 16.0 +/- 2.2, which was also lower significantly compared with baseline value (P < 0.05). The induction of sedation produced a significant decrease in SBP and DBP (P < 0.05) and no significant changes in heart rate (P > 0.05). At the end of the procedure, SBP, DBP and HR returned to the baseline value. The anoxemia happened in 11 cases, apnea in 5 cases and restlessness in 2. No nausea and vomiting occurred. The anesthesia duration and consumption of midazolam, propofol and sufentanil were (101.1 +/- 42.5) min, (8.4 +/- 3.7) mg, (189.1 +/- 88.7) mg and (18.2 +/- 5.6) microg respectively. In an interview on the first postoperative day, 96% (78/ 81) of the patients were satisfied with their anesthesia and were willing to receive the same anesthetic technique if necessary in the future.
  
  
  CONCLUSIONS
  Conscious sedation with midazolam, propofol and sufentanil is an effective anesthetic technique for patients in plastic surgery.
authors.affiliation: Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
authors.forename: Jing-Hu
authors.initials: JH
authors.lastname: Sui
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Liu
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Deng
authors.forename: Geng-Zhi
authors.initials: GZ
authors.lastname: Tang
authors.forename: Ling-Xin
authors.initials: LX
authors.lastname: Wei
authors.forename: Dong
authors.initials: D
authors.lastname: Yang
authors.forename: Ju-Hui
authors.initials: JH
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage; D017409:Sufentanil / Q000008:administration & dosage; D013518:Surgery, Plastic; D055815:Young Adult
chemical_list: D017409:Sufentanil; D008874:Midazolam; D015742:Propofol