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Comparison of patient-controlled sedation with either methohexitone or propofol
Abstract:
We studied 42 patients undergoing oral surgery under local anaesthesia with i.v. sedation, allocated randomly to receive either methohexitone (group M) or propofol (group P) for patient-controlled sedation (PCS). Group M patients self-administered 2.5-mg (0.5 ml) bolus doses of methohexitone and group P, 5-mg (0.5 ml) doses of propofol, without a lockout. The 0.5-ml bolus dose was delivered over 7.2 s for both drugs. The procedure was completed satisfactorily in all patients. Patients in both groups achieved their desired levels of sedation. No patient lost verbal contact. Group M patients had higher heart rates during the procedure. The lowest SpO2 values recorded were 92% and 95% for group P and group M, respectively. Immediately after operation patients in group M reported that they felt more sleepy than those in group P (P < 0.01) but there were no differences at subsequent times. The results of the psychomotor tests were comparable for the two groups after operation, except for the "posting box task" at 15 min after operation when the mean decrement (compared with preoperative performance) was -3% for group P and -13% for group M (P < 0.05). More patients in group P complained of pain in their hand. We conclude that methohexitone is a suitable alternative drug to propofol for PCS.
Insights
Methohexitone and propofol are effective for patient-controlled sedation (PCS) during oral surgery. Methohexitone offers a suitable alternative to propofol, with comparable sedation and psychomotor recovery, but less post-operative hand pain.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Patient-controlled sedation (PCS) is utilized in oral surgery.
- Propofol is a common agent for intravenous (IV) sedation.
- Evaluating alternatives for IV sedation is important for patient care.
Purpose of the Study:
- To compare the efficacy and safety of methohexitone versus propofol for patient-controlled sedation (PCS) during oral surgery.
- To assess patient satisfaction and recovery profiles between the two sedative agents.
Main Methods:
- A randomized study involving 42 patients undergoing oral surgery under local anesthesia with IV sedation.
- Patients received either methohexitone (2.5 mg bolus) or propofol (5 mg bolus) via patient-controlled sedation (PCS) without a lockout.
- Sedation levels, vital signs (heart rate, SpO2), verbal contact, post-operative sleepiness, and psychomotor performance were monitored.
Main Results:
- Both methohexitone and propofol provided satisfactory sedation without loss of verbal contact.
- Methohexitone group (M) showed higher heart rates and SpO2 (95%) compared to propofol group (P) (92%).
- Group M reported increased sleepiness immediately post-operation, but psychomotor tests were comparable, except for the "posting box task" where Group P performed better.
Conclusions:
- Methohexitone is a viable alternative to propofol for patient-controlled sedation (PCS) in oral surgery.
- Methohexitone sedation resulted in comparable procedural success and psychomotor recovery.
- Fewer patients in the methohexitone group reported post-operative hand pain.