Neural Blockade under the Hypnotic Sedation Using Target Controlled Infusion of Propofol

Oh, Wan Soo; An, Woo Yong; Hong, Ki Hyuk

Abstract

BACKGROUND: The use of sedative and analgesic adjuncts during local and regional anesthesia can enhance patient comfort and improve operative conditions. Because propofol has well-known rapid recovery characterized by "clear-headedness", its use intraoperatively may result in less postoperative sedation and thus shorten the time for discharge from the hospital. The purpose of this study was designed to evaluate the patient's satisfaction of hypnotic neural blockade using target controlled infusion (TCI) of propofol.
METHODS
Sixty-two patients scheduled to undergo elective neural blockade in the operating room were selected for this study. They had taken previous neural blockade in the awakening state. Without premedication, they arrived at the operating room via pain clinic. After proper positioning, vital signs, pulse oximetry and respiratory rate were monitored. TCI of propofol was started at a target concentration of 3.0 microgram/ml and an induction time of 3 minutes. We regarded loss of hand grasping power as induction of hypnosis. Subsequently, target concentration was adjusted to a range of 0.8+/-1.6 times the effector site concentration at induction. Propofol infusion was stopped when the procedure was finished and the patients were transported to the recovery room and discharged. The satisfaction of patients concerning hypnotic neural blockade were evaluated by a six point numerical rating scale (6:best-1:worst)
RESULTS
Patient withdrawal movement during local anesthetic infiltration occured in 17 patients. Recovery time was 4.7 +/-3.0 min (mean +/- S.D.). Patient's satisfaction for hypnotic neural blockade was 5 [3-6] (median [range]).
CONCLUSION
Patient's satisfaction for hypnotic neural blockade was high. TCI of propofol serves as a safe sedation model during neural blockade without any residual sequelae.