Korean J Anesthesiol.  2004 Oct;47(4):542-546. 10.4097/kjae.2004.47.4.542.

The Effect of Monitored Anesthesia Care using Alfentanil and Ketorolac in Patients Undergoing Endoscopic Sinus Surgery

• Oh IY
• Lim BW
• Lee SH
• Kim YJ
• Cho CK
• Choi HY
• Park CK

• KMID: 2299292
• DOI: http://doi.org/10.4097/kjae.2004.47.4.542

Abstract

BACKGROUND: Monitored anesthesia care (MAC) has become increasingly important as a means of ensuring patient comfort, safety and satisfaction during surgery under local anesthesia. The purpose of this study was to evaluate the effect of monitored anesthesia care using alfentanil and ketorolac in patients undergoing endoscopic sinus surgery (ESS).
METHODS
We studied 47 adult patients premedicated with glycopyrrolate 0.2 mg and midazolam 0.02 mg/kg IV. Using a 5.0 endotracheal tube, 5 L/min of oxygen was delivered via mouth. A mixture of 30 mg of ketorolac and 2,500microgram of alfentanil in 25 ml of saline was infused to patients at a rate of 1microgram/kg/min alfentanil after a bolus injection of 5microgram/kg alfentanil before operation. During operations we monitered vital signs, SpO2, OAA/S (Observer's Assessment of Alertness/Sedation) scale and BIS scores. Six hours postoperatively we assessed patient degree of satisfaction via NRS (1-10) with the anesthetic technique and side effects.
RESULTS
Mean duration of drug infusion was 35 +/- 10.1 min, and the mean infusion rate of alfentanil was 1.09 +/- 0.23microgram/kg/min. Significant differences were observed between OAA/S scale scores at 10 min and 30 min after drug infusion and those in the waiting room (4.63, 4.65 vs 5, P <0.05)(Fig. 4). The mean patient satisfaction score was 8.3 out of 10, and 93.6% (44/47) of patients said they would recommend this anesthetic technique to others for ESS.
CONCLUSIONS
Our results suggest that MAC using a mixture of alfentanil and ketorolac during ESS is a good way of relieving patient anxiety and pain without respiratory depression or excessive sedation. This study also showed a high level of patient satisfaction for those undergoing ESS under local anesthesia.

Keyword

alfentanil; endoscopic sinus surgery; ketorolac; monitored anesthesia care

MeSH Terms

Adult
Alfentanil*
Anesthesia*
Anesthesia, Local
Anxiety
Glycopyrrolate
Humans
Ketorolac*
Midazolam
Mouth
Oxygen
Patient Satisfaction
Respiratory Insufficiency
Vital Signs
Alfentanil
Glycopyrrolate
Ketorolac
Midazolam
Oxygen