Patient controlled sedation during central neuraxial anesthesia

Area of Science:

• Anesthesiology
• Surgical Care
• Patient Comfort Management

Background:

• Patient-controlled sedation (PCS) empowers patients to self-administer sedatives for optimal comfort.
• Its application during surgery under central neuraxial blockade warrants evaluation.

Purpose of the Study:

• To evaluate the utilization and patient acceptance of PCS during surgical procedures performed under central neuraxial blockade.
• To assess the safety and efficacy of a specific propofol regimen within the PCS framework.

Main Methods:

• A prospective, cross-sectional study involving 160 adult patients undergoing urologic procedures under central neuraxial block.
• Propofol (1%) 2 ml in 2 min was administered via PCS, with data collected on activation times, sedation levels, hemodynamics, and patient satisfaction.
• Statistical analysis included correlation and multivariate logistic regression to identify factors influencing PCS use.

Main Results:

• 83% of patients activated PCS, with earlier activation observed in females and during longer surgeries (>90 min).
• The propofol regimen was safe, maintaining hemodynamic stability without significant adverse events like apnea or hypotension.
• A high acceptance rate was reported, with 91% of patients rating the PCS technique as excellent to good.

Conclusions:

• Patient-controlled sedation using the specified propofol regimen is a safe and highly acceptable option for patients undergoing surgery under central neuraxial blockade.
• PCS effectively enhances patient comfort and satisfaction during these procedures.