Monitored anaesthesia care with subhypnotic doses of propofol during cystoscopies Sistoskopilerde subhipnotik dozlarda propofol ile "monitorize anestezi bakimi" uygulamasi
Turk Anesteziyoloji ve Reanimasyon, cilt.29, sa.3, ss.118-123, 2001 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 3
- Basım Tarihi: 2001
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.118-123
- Anahtar Kelimeler: Cystoscopy, Monitored anaesthesia care, Outpatient anaesthesia, Propofol, Sedation
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
The effects of application of propofol in subhypnotic doses for "monitored anaesthesia care" (MAC) during control cystoscopies have been examined in a prospective, randomised, clinical study. 84 ASA II-III class patients who have had previous control cystoscopies with general anaesthesia have been studies in 3 groups. After application of fentanyl 1 uμg/kg IV and local anaesthetic lubricant through mea, patients in G1 (n=18) received no further medication; G2 (n=33) propofol until the patients speech became "slurring" (OAA/S score =3 (1=alert; 5=asleep)) (max. dose 1 mg/kg); and in G3 (n=33) propofol in hypnotic doses (2-3 mg/kg) until the loss of eye-lash reflex. If necessary, supplemental doses of propofol 10 mg have been added. Changes in hemodynamic parameters of more then 20% of the preinduction values, postoperative pain (VAS) have been recorded; patients were asked for a comparison with previous cystoscopies and urologists were asked for the surgical quality (1=bad; 4=excellent). In G1, a significant (p<0.05) incidence of tachycardia (89%), hypertension (78%) and a significantly high VAS (7.2±4.3) were observed. Between G2 and G3 there was no difference in tachycardia incidence and VAS (12% vs 12%, and 1.9±1.5 vs 2.2±1.5, respectively); but patients in G3 became significantly more hypotensive (48% vs 12%). All the patients in G2 have reported to feel "better" then the previous procedures, where general anaesthesia has been used. Surgical comfort was worse in G1 with no differences between G2 and G3 (1.7±0.6; 3.1±0.5; 3±0.6, respectively). It has been concluded that MAC with subhypnotic doses of propofol appears to be a safe and appropriate application with well according specifications for outpatient anaesthesia procedures.