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Related Experiment Videos

[Is patient-controlled sedation good for elderly patients?]

T Kawabata1, J Tokumine, I Takara

  • 1Department of Anesthesiology, School of Medicine, University of the Ryukyus.

Masui. the Japanese Journal of Anesthesiology
|February 17, 1999
PubMed
Summary

Patient-controlled sedation (PCS) using propofol is safe and effective for elderly patients undergoing knee surgery with epidural anesthesia. This method provides sedation comparable to anesthesiologist-controlled sedation (ACS) with similar patient and surgeon satisfaction.

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Area of Science:

  • Anesthesiology
  • Geriatric Medicine
  • Surgical Sedation

Background:

  • Elderly patients undergoing surgery require careful sedation management.
  • Epidural anesthesia is commonly used for knee arthroplasty.
  • Patient-controlled sedation (PCS) offers potential advantages in sedation delivery.

Purpose of the Study:

  • To evaluate the safety and efficacy of intra-operative patient-controlled sedation (PCS) with propofol in elderly patients.
  • To compare propofol PCS with anesthesiologist-controlled sedation (ACS) during knee arthroplasty under epidural anesthesia.

Main Methods:

  • A randomized study comparing propofol PCS (n=6) and ACS (n=5) in elderly patients undergoing knee arthroplasty under epidural anesthesia.
  • Sedation levels, vital signs, blood gas analysis, and plasma propofol levels were monitored.

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  • Patient and surgeon satisfaction surveys were conducted.

    • Main Results:

    • Patients in the PCS group received a lower mean dose of propofol (1.9 mg.kg-1) compared to the ACS group (2.9 mg.kg-1).
    • Procedure duration was similar in both groups (PCS: 147 min, ACS: 142 min).
    • Patient and surgeon satisfaction and complication incidence were similar between the PCS and ACS groups.

    Conclusions:

    • Intra-operative patient-controlled sedation (PCS) with propofol is a safe and effective sedation technique for elderly patients undergoing knee arthroplasty with epidural anesthesia.
    • PCS provides comparable sedation quality to anesthesiologist-controlled sedation (ACS) in this patient population.
    • PCS may allow for reduced propofol administration while maintaining satisfactory sedation and outcomes.