Propofol IV Sedation during Epidural Anesthesia in the Elderly

Kim, Dong Yeon

Abstract

BACKGROUND
The ideal sedative medication for use during regional anesthesia would provide for an easily titrable level of sedation, predictable amnesia, decreased anxiety, while providing for a rapid recovery with minimal side effects. We investigated the clinical effects produced by three different infusion regimens for propofol during regional anesthesia.
METHODS
Thirty elderly male patients undergoing urologic surgery were randomly enrolled into three groups, who were receiving epidural anesthesia. In groups I-III, loading doses of propofol equal to 0.6, 0.8, or 1.0 mg/kg intravenously, respectively, were followed by fixed rate propofol infusions of 1.2, 1.6, or 2.0 mg/kg/hr, respectively. Sedation was assessed by a blinded observer using sedation score. Intraoperative amnesia was assessed using picture recall.
RESULTS
Sedation scores increased in a dose-dependent fashion (2.5+/-0.5, 3.1+/- 0.5, and 3.9+/- 0.8 in groups I-III, respectively). Intraoperative amnesia was more commonly observed in the higher-dosage groups (30%, 20%, and 0% of patients in groups I-III, respectively). There was no significant changes in hemodynamic and respiratory variables. The degree of satisfaction in propofol sedation was rated as good on 90% of the patients.
CONCLUSIONS
Propofol infusion during regional anesthesia was an effective sedative technique with rapid recovery, high degree of satisfaction and minimal side effects.