[Application of conscious sedation with dexmedetomidine and sufentanil in patient for plastic surgery].
OBJECTIVE
To observe the effectiveness of conscious sedation with dexmedetomidine and sufentanil in patients for plastic surgery.


METHODS
Forty patients scheduled for elective plastic surgery under conscious sedation were infused 1 µg/kg intravenously within 15 minutes as loading dose followed by a continuous infusion of dexmedetomidine (0.5 µg·kg⁻¹·h⁻¹) and sufentanil (0.07 µg·kg⁻¹·h⁻¹) respectively. Sufentanil 0.05 µg/kg and midazolam 0.025 mg/kg were administrated intravenously 5 minutes before local infiltration, and then a bolus of sufentanil or midazolam was given as needed to maintain OAA/S score of 11 during the procedure. The drug infusion was discontinued at 5 to 10 min before the end of the surgical procedure. The complications (i.e. anoxemia, apnea, bradycardia, restlessness, nausea, vomiting, crying and excitation), if any, anesthesia duration and drug consumption were recorded. 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 sedative analgesic medications and should they require a similar surgical procedure in the future.


RESULTS
The OAA/S score decreased from 20.0 ± 0 to 11.5 ± 2.5 after patients being infused the loading dose of dexmedetomidine, and was maintained 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score return to 16.1 ± 2.8. The induction of sedation produced a significant decrease in HR (P < 0.05) and no significant changes in SBP, DBP and RR values (P > 0.05). There were 38 patients completed their procedures under conscious sedation, and there were incident of crying and bradycardia in 5 and 2 patients respectively. The anesthesia duration and consumption of dexmedetomidine, sufentanil and midazolam were (128 ± 47) min, (116 ± 43) µg, (10 ± 5) µg and (2 ± 1) mg respectively. In an interview on the first postoperative day, there were 13 patients complaining no memory, 17 patients complaining fuzzy memory and 8 patients complaining awake during the procedure, respectively. There were 92% of the patients willing to receive the same anesthetic technique again in the future.


CONCLUSIONS
Conscious sedation with dexmedetomidine and sufentanil is an effective anesthetic technique in patients for plastic surgery.
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Jinghu
J
Sui
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China. Email: dengxiaoming2003@sina.com.
Xiaoming
X
Deng
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Xiaowen
X
Liu
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Yuhui
Y
Wang
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Jinhua
J
Jin
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Lingxin
L
Wei
Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Dong
D
Yang
D000293:Adolescent; D000328:Adult; D016292:Procedural Sedation / Q000379:methods*; D020927:Dexmedetomidine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017409:Sufentanil; D013518:Surgery, Plastic; D055815:Young Adult
D020927:Dexmedetomidine; D017409:Sufentanil