Faculty Collaboration Database

Premedication modifies the quality of sedation with propofol during regional anesthesia. Can J Anaesth 2001 Mar;48(3):284-7

Date

04/18/2001

Pubmed ID

11305831

DOI

10.1007/BF03019760

Scopus ID

2-s2.0-0035049177 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

PURPOSE: To determine the effects of diazepam or clonidine on the quality of sedation with propofol during regional anesthesia.

METHODS: In a prospective randomised, controlled, double-blinded study, 60 patients undergoing elective gynecological surgery were studied. They were given premedication with 0.15-mg clonidine (Group-CL, n=20), 5-mg diazepam (Group-DZ, n = 20), or placebo (Group-P, n = 20) po. After spinal anesthesia was established, sedation was provided with propofol and controlled using a five-point sedation score at 3, "eyes closed but rousable to command", and 4, "eyes closed but rousable to mild physical stimulation". During sedation, blinded anesthesiologist recorded occurrence of complications. At two hours after end of sedation, patients were asked if they had intraoperative dream and memory.

RESULTS: The loading dose, steady-state infusion rate, and overall mean infusion rate in Group-CL were 0.80 mg x kg(-1), 2.35 mg x kg(-1) x hr(-1) and 2.89 mg x kg(-1) x hr(-1), compared with 0.97 mg x kg(-1), 3.13 mg x kg(-1) x hr(-1) and 3.59 mg x kg(-1) x hr(-1) in Group-DZ, and 1.38 mg x kg(-1), 4.10 mg x kg(-1) x hr(-1) and 4.36 mg x kg(-1) x hr(-1) in Group-P, respectively. Indices of both Group-CL (P < 0.001) and Group-DZ (P < 0.05) were smaller than those of Group-P Moreover, clonidine reduced the incidence of uncontrolled movement (P < 0.01), while diazepam reduced the incidence of intraoperative memory and increased the incidence of dream (P < 0.05). Premedication did not affect the incidence of other complications.

CONCLUSION: Both premedicants reduced propofol requirements and exerted beneficial effects on the incidence of some complications during sedation with propofol as an adjunct to regional anesthesia.

Author List

Nakagawa M, Mammoto T, Sakai T, Kishi Y, Mashimo T

Author

Tadanori Mammoto MD, PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Anesthesia, Conduction
Awareness
Blood Gas Analysis
Double-Blind Method
Female
Gynecologic Surgical Procedures
Humans
Hypnotics and Sedatives
Intraoperative Complications
Laparotomy
Middle Aged
Monitoring, Intraoperative
Premedication
Propofol
Respiratory Function Tests