Incremental bolus versus a continuous infusion of propofol for deep sedation/general anesthesia during dentoalveolar...

This article compared the use of the traditional incremental bolus technique with the continuous infusion technique for the administration of propofol for deep sedation/general anesthesia.

Patients were sedated with midazolam and fentanyl and then had maintenance of an anesthetic state achieved with propofol administered by either of the two techniques. Data were collected to evaluate the overall surgical/anesthetic procedure, movement of the patient, and his or her hemodynamic status.

Both groups received a mean maintenance dose of propofol exceeding 6 mg/kg/hr. However, the patients in the continuous infusion group received a statistically greater maintenance dose (continuous infusion + supplemental vs incremental bolus). All patients were maintained in a deep sedation/general anesthetic state. Respiratory and blood pressure values were comparable in both groups. However, the continuous infusion group showed improved hemodynamic stability manifested as fewer fluctuations in heart rate. Visual analog scale (VAS) questionnaires completed by the surgeon and surgical assistant reported less patient movement and improved surgical/anesthetic conditions with the continuous infusion technique. Recovery of the two groups was comparable.

This study, although finding advantages in the continuous infusion technique, showed satisfactory conditions associated with both techniques.