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Query: UMLS:C0600097 (Sedation)
 1,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Propofol by continuous intravenous infusion was used as an alternative to nitrous oxide/oxygen for conscious sedation in 19 patients undergoing out-patient dental treatment. Patients were either extremely anxious or mentally and/or physically handicapped. Propofol was administered by a syringe pump at an initial rate of 3 mg/kg/hour. During the procedure the infusion rate was adjusted to attain and maintain the desired level of conscious sedation. The mean time from starting the propofol infusion until reaching the required level of sedation was 11.5 (SD 3.5) minutes. The mean infusion rate was 3.6 (SD 0.65) mg/kg/hour. The average duration of the dental procedure was 55.9 (SD 18.8) minutes. Sedation was satisfactory in all but two patients. There were no side-effects. Recovery was rapid after stopping the infusion. It is concluded that propofol is an acceptable alternative to nitrous oxide/oxygen for conscious sedation in the dental surgery.
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PMID:Conscious sedation with propofol in dentistry. 182 74

Sedation with propofol was achieved in 10 patients with COPD admitted into ICU because of acute respiratory insufficiency. Propofol dosage was 1-3 mg/kg-1/h and the testing period 30-144 h. Curarization was non required. Sedation with propofol, valued by means of Ramsay Score, was suitable in all tested patients. Bio-humoral and instrumental monitoring have not evidenced side effects.
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PMID:[Sedation with propofol in COPD patients in the ICU]. 194 65

Ten patients, with a range of illness severity, received a continuous 8-hour infusion of undiluted propofol for sedation while undergoing mechanical ventilation in a general intensive care unit. The level of sedation was assessed hourly and measurements were made of haemodynamic, respiratory, haematological and biochemical variables. Sedation remained satisfactory in most patients throughout the study period, with only occasional alterations in infusion rate, and eight patients required further sedative therapy within 45 minutes of discontinuation of the propofol infusion. Arterial pressure tended to decrease from baseline values; mean and diastolic pressures demonstrated a significant decrease (p less than 0.05) at 4, 7 and 8 hours during the infusion. Adrenal steroidogenesis was not inhibited significantly. Propofol infusion proved to be a useful and readily controllable sedative agent, and discontinuation of the drug was followed by rapid recovery in most cases. The critically ill may be particularly sensitive to the cardiovascular depressant properties of the drug.
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PMID:Propofol infusion for sedation in intensive care. 349 30

We have compared the sedative and amnesic effects of midazolam and propofol in 35 volunteers. Sedation was measured by simple reaction time immediately before and after a bolus injection and 1 h after the commencement of a subsequent continuous infusion. Memory was measured three times using two memory tests: perceptual facilitation provided an implicit memory measure and recognition provided an explicit memory measure. Propofol and midazolam had similar sedative effects both immediately after bolus doses and after 1-h continuous infusions of the drugs. In contrast, midazolam had a more profound amnesic effect than propofol on the recognition memory test. The drugs had little effect on performance with the implicit memory test. Performance on the memory tests was unrelated to sedation.
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PMID:Comparison of the sedative and amnesic effects of midazolam and propofol. 832 51

Sedation may influence the responses of some experimental pain models used to test analgesic efficacy. In this study we compared the effects of a sedative (propofol) and analgesic (alfentanil) on: nociceptive reflex to single and repeated electrical stimulations; mechanical pressure pain; and evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation. We studied 12 healthy volunteers with two subanaesthetic concentrations of propofol and two analgesic concentrations of alfentanil. Both propofol and alfentanil increased the threshold for nociceptive reflex to single electrical stimulations, but only alfentanil increased the threshold for nociceptive reflex to repeated electrical stimulations. The pressure pain tolerance thresholds were increased significantly by alfentanil, whereas propofol significantly decreased the thresholds (hyperalgesia). Propofol and alfentanil induced similar reductions in the amplitudes of the evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation, whereas only alfentanil reduced the perceived pain to nociceptive stimulations. We have shown that sedation can influence both the psychophysical and electrophysiological responses of some experimental pain tests used to measure analgesic efficacy, and that propofol in subhypnotic doses, has no analgesic effect on painful electrical and heat stimulations, but has a hyperalgesic effect on mechanical pressure pain.
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PMID:Psychophysical and electrophysiological responses to experimental pain may be influenced by sedation: comparison of the effects of a hypnotic (propofol) and an analgesic (alfentanil). 888 19

Postoperative nausea and vomiting (PONV) are unpleasant, often underestimated side effects of anaesthesia and surgery, not devoid of medical complications. Prevention with antiemetics is only partially effective. Propofol has been shown recently to possess antiemetic properties in several situations. In this prospective, randomized, controlled trial, we have compared the antiemetic efficacy of subhypnotic doses of propofol, with Intralipid as placebo, after thyroidectomy. We studied 64 patients of both sexes, aged 22-71 yr, ASA I or II, undergoing thyroidectomy. After premedication with a benzodiazepine, balanced anaesthesia was produced with isoflurane and nitrous oxide in oxygen, and supplementary analgesia with fentanyl i.v. as required. Postoperative analgesia was provided with non-opioids, and piritramide 0.25 mg kg-1 i.m. on demand. Patients were allocated randomly and blindly to receive a 20-h infusion of either propofol or 10% Intralipid 0.1 ml kg-1 h-1. Intralipid, the excipient of propofol, was chosen as placebo as it is devoid of antiemetic effects. Sedation scores, respiratory and cardiovascular variables, and incidence of PONV were assessed every 4 h for 24 h. Pulse oximetry and ECG were monitored continuously. Both groups were comparable in characteristics, surgical and anaesthesia procedures, amount of opioids given during and after operation, and total amount of the study drug infused after operation. Occurrence of PONV was similar before the start (propofol 41%, Intralipid 50%) and after completion (propofol 0.64%, Intralipid 1.6%) of infusion and decreased with time in both groups during the infusion. However, symptoms were reduced to nil with propofol but persisted and were more severe with Intralipid during infusion (P < or = 0.01). The overall incidence of PONV during infusion was 10% (three of 32 patients) in the propofol group and 65% (21 of 32 patients) in the Intralipid group. Cardiovascular and respiratory variables, and SpO2 were unaltered, and sedation decreased similarly with time in both groups. We conclude that propofol, given at subhypnotic doses, effectively reduced the incidence of PONV without untoward sedative or cardiovascular effects.
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PMID:Antiemetic effect of subhypnotic doses of propofol after thyroidectomy. 894 29

Propofol (P) is increasingly used as a sedative during regional anesthesia. Providing titratable sedation and rapid recovery, it can compromise hemodynamic stability. However, in combination with ketamine (K), it provides stable hemodynamics during total intravenous anesthesia, avoiding emergence phenomena. We compared the efficacy, respiratory and hemodynamic profiles, and side effects of these two sedative regimes in patients undergoing spinal anesthesia. Forty patients, ASA physical status I and II, undergoing urologic or orthopedic procedures were randomly assigned to one of two groups (n = 20 each). Group 1 (P + K) received initial doses of 0.4 mg/kg P, 0.1 mg/kg K, followed by an intravenous infusion of 1.2 mg x kg(-1) x h(-1) and 0.3 mg x kg(-1) x h(-1), respectively. Group 2 (P) received bolus 0.5 mg/kg and infusion 1.5 mg x kg(-1) x h(-1). Subsequent infusion rates were titrated to a predetermined sedation level using a 5-point score. Heart rate, arterial pressure, respiratory rate, oxygen saturation end-tidal CO2, and oxygen requirements were recorded. Sedation scores were similar for both groups. There was no difference in total propofol requirements between Group 1 (146 +/- 94 mg) and Group 2 (137 +/- 52 mg) (mean +/- SD). Mean arterial pressure was significantly higher in the P + K group, e.g., 91 mm Hg (86-94) vs 75 mm Hg (69-83) at 30 min (mean +/- SD). Administration of vasopressors and fluids as well as recovery and emergence phenomena were similar between groups. Although the described additive effect of propofol and ketamine was not confirmed, the combination conferred hemodynamic stability during spinal anesthesia.
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PMID:A comparison of propofol with a propofol-ketamine combination for sedation during spinal anesthesia. 917 13

Endoscopic manometry of the sphincter Oddi (SO) is a sophisticated method which requires a cooperative patient. Therefore, during endoscopic manometry sufficient i.v. sedation is crucial, and additionally must no affect SO-motility. In a pilot trial SO-motility was determined in ten patients with suspected SO-dysfunction (SOD) under initial sedation with 4.8 +/- 1 mg midazolam (baseline), and 3 min after an i.v. bolus of 50 mg of propofol. In addition, endoscopic manometry was performed in 57 consecutive patients with suspected SOD from 10/94-9/95 under sedation with midazolam (6.2 +/- 1.6 mg), and from 10/95-9/96 with propofol (268 +/- 111 mg). Sedation was always performed by an independent physician according to a standardized protocol. Neither the SO-baseline pressure nor the parameters of phasic SO-motility were significantly altered by propofol (including two patients with proven SOD). Propofol causes a more rapid onset of sedation, and the time interval to obtain successful biliary cannulation was shorter than under midazolam (p < 0.05). Successful manometric recordings could be obtained in 82% of the patients under midazolam but in 96% of the patients under propofol-sedation (p < 0.05), respectively. The patient cooperation was significantly better rated (by the endoscopist) in the propofol group than in the midazolam group (p < 0.01). The blood pressure and the heart rate were not significantly affected in both groups, however, propofol caused a significant decrease of the oxygen saturation (p < 0.05). Accordingly, an apnea episode had to be mastered by mask ventilation via ambu bag in one patient under propofol-sedation (uneventful recovery). In the midazolam group flumazenil-administration was necessary in four patients. The post-procedure recovery was faster after propofol--than after midazolam-sedation (p < 0.05). In conclusion, propofol is suitable for i.v. sedation during endoscopic manometry of the spincter of Oddi.
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PMID:[Propofol sedation in endoscopic manometry of Oddi's sphincter]. 1023 94

Flexible fibreoptic bronchoscopy (FOB) has become a useful diagnostic and therapeutic procedure in children. We investigated 26 patients (3-14 years) for FOB using a new sedation strategy. All patients received oral premedication and inhalation of topical anaesthetic. Sedation for bronchoscopy was achieved with a continuous infusion of remifentanil and intermittent boluses of propofol. Propofol injection was repeated if sedation was inadequate. Sedation could be successfully performed in all children without adverse effects. Endtidal CO2 concentration and arterial oxygen saturation remained stable throughout the study. All children were awake 5+/-1.3 min after stopping remifentanil infusion. Sedation with remifentanil/propofol is a new sedation strategy for diagnostic flexible paediatric bronchoscopy in children with spontaneous ventilation.
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PMID:Remifentanil and propofol for sedation in children and young adolescents undergoing diagnostic flexible bronchoscopy. 1063 11

AIM: Sedation regimens for toddlers and preschoolers are still open for further studies. Propofol is rapidly finding its way into medical routine. The aim of this pilot study was to re-evaluate the need for sedation in young children and to further investigate the use of propofol as an intravenous agent combined with the use of a flexible laryngeal mask for treatment of the youngest group of dental patients. METHODS: A randomised clinical trial with 54 children involved was conducted comparing one group receiving propofol sedation only with a study group receiving propofol with the use of a reinforced laryngeal mask. Assessments were made as to depth of sedation, quantity of propofol used, desaturations and recovery times. RESULTS: The use of a laryngeal mask improved the treatment conditions by decreasing the number of desaturations during treatment (p</=0.001, t=5.74). When using a laryngeal mask, the average amount (in ml) of propofol used was significantly higher (p</=0.016, t=-2.22) and the average waking up time in minutes significantly longer (p</=0.016, t=-2.23). CONCLUSION: It was also found that deepening the sedation to be able to insert the laryngeal mask effectively reached such a level that it should be renamed as anaesthesia, thereby possibly limiting its use to hospital settings. The study supported, however, the safety aspects of the laryngeal mask.
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PMID:Dental treatment of children using propofol and a laryngeal mask. 1287 Oct 12


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