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Conscious sedation for middle ear surgeries: A comparison between fentanyl-propofol and fentanyl-midazolam infusion.

Thota RS, Ambardekar M, Likhate P - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: The mean visual analog scale (VAS) score for surgeons and patients was not statistically significant in both the groups.Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better.Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Mumbai, Maharashtra, India.

ABSTRACT

Introduction and aim: Middle ear surgeries can be performed under local anesthesia and sedation and can be well tolerated by the patient with minimal discomfort. This study was undertaken to compare two techniques of conscious sedation, intravenous midazolam, and propofol infusion for tympanoplasty.

Materials and methods: Forty patients scheduled for right or left tympanoplasty. American Society of Anesthesiologists I or II in age group 18-75 years were included in the study. The patients were randomly allocated into one of the two groups to receive either propofol (group I) or midazolam (group II).

Results: The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07). The modified Ramsay sedation scale was not statistically significant in both the groups. In group I, 70% of the patients and 95% of the patients in group II had amnesia during the surgery (P = 0.091). The mean visual analog scale (VAS) score for surgeons and patients was not statistically significant in both the groups. In group I there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02). There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034) and patients (P = 0.039) in group I.

Conclusion: Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better. Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

No MeSH data available.


Related in: MedlinePlus

Amnesia in group I and group II
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Figure 1: Amnesia in group I and group II

Mentions: Of the 40 patients studied who were operated for tympanoplasty, males and females, as well as the site of tympanoplasty, were equally distributed in both the groups. The mean age in the group I was 29.10 ± 10.24 years and 33.00 ± 13.44 years in group II (P = 0.30). Two patients in group I were ASA PS II, while 3 patients from group II were ASA PS II. The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07). The modified Ramsay sedation scale was not statistically significant in both the groups [Table 1]. In group I, 70% of the patients and 95% of the patients in group II [Figure 1] had amnesia during the surgery (P = 0.091). General complications like inappropriate movements, excessive pain and nausea and vomiting are shown in Table 2. In group I, 35% of the patients and in group II 30% had some movements during the surgery (P = 1.00), and the dose of propofol and midazolam were increased in groups I and II respectively so that the patients did not move during the procedure. Similarly, 35% of the patients in group I and 30% of the patients in group II had excessive pain during the surgery (P = 1.00) and required small doses of fentanyl and local anesthetic infiltration. One patient in group II had vomiting, but none of the patients in group II had any nausea or vomiting (P = 1.00). None of the patients in both the groups had any desaturation or hypoventilation, while 1 patient in group I had snoring during the surgery. The average total dose of fentanyl was 82.70 ± 26.12 μg in group I and 83.10 ± 17.55 μg in group II (P = 0.07). The mean VAS score for surgeons and for patients was not statistically significant in both the groups [Table 1]. In group I, there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02). There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034) and patients (P = 0.039) in group I.


Conscious sedation for middle ear surgeries: A comparison between fentanyl-propofol and fentanyl-midazolam infusion.

Thota RS, Ambardekar M, Likhate P - Saudi J Anaesth (2015 Apr-Jun)

Amnesia in group I and group II
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374213&req=5

Figure 1: Amnesia in group I and group II
Mentions: Of the 40 patients studied who were operated for tympanoplasty, males and females, as well as the site of tympanoplasty, were equally distributed in both the groups. The mean age in the group I was 29.10 ± 10.24 years and 33.00 ± 13.44 years in group II (P = 0.30). Two patients in group I were ASA PS II, while 3 patients from group II were ASA PS II. The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07). The modified Ramsay sedation scale was not statistically significant in both the groups [Table 1]. In group I, 70% of the patients and 95% of the patients in group II [Figure 1] had amnesia during the surgery (P = 0.091). General complications like inappropriate movements, excessive pain and nausea and vomiting are shown in Table 2. In group I, 35% of the patients and in group II 30% had some movements during the surgery (P = 1.00), and the dose of propofol and midazolam were increased in groups I and II respectively so that the patients did not move during the procedure. Similarly, 35% of the patients in group I and 30% of the patients in group II had excessive pain during the surgery (P = 1.00) and required small doses of fentanyl and local anesthetic infiltration. One patient in group II had vomiting, but none of the patients in group II had any nausea or vomiting (P = 1.00). None of the patients in both the groups had any desaturation or hypoventilation, while 1 patient in group I had snoring during the surgery. The average total dose of fentanyl was 82.70 ± 26.12 μg in group I and 83.10 ± 17.55 μg in group II (P = 0.07). The mean VAS score for surgeons and for patients was not statistically significant in both the groups [Table 1]. In group I, there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02). There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034) and patients (P = 0.039) in group I.

Bottom Line: The mean visual analog scale (VAS) score for surgeons and patients was not statistically significant in both the groups.Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better.Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Mumbai, Maharashtra, India.

ABSTRACT

Introduction and aim: Middle ear surgeries can be performed under local anesthesia and sedation and can be well tolerated by the patient with minimal discomfort. This study was undertaken to compare two techniques of conscious sedation, intravenous midazolam, and propofol infusion for tympanoplasty.

Materials and methods: Forty patients scheduled for right or left tympanoplasty. American Society of Anesthesiologists I or II in age group 18-75 years were included in the study. The patients were randomly allocated into one of the two groups to receive either propofol (group I) or midazolam (group II).

Results: The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07). The modified Ramsay sedation scale was not statistically significant in both the groups. In group I, 70% of the patients and 95% of the patients in group II had amnesia during the surgery (P = 0.091). The mean visual analog scale (VAS) score for surgeons and patients was not statistically significant in both the groups. In group I there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02). There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034) and patients (P = 0.039) in group I.

Conclusion: Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better. Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

No MeSH data available.


Related in: MedlinePlus