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Balanced conscious sedation with intravenous induction and inhalational maintenance for patients requiring endoscopic and/or surgical procedures.
Eur J Anaesthesiol. 2007 Feb; 24(2):116-21.EJ

Abstract

BACKGROUND AND OBJECTIVE

The use of inhalation sedation with sub-anaesthetic concentrations of sevoflurane and nitrous oxide mixture is expected to reduce amounts of intravenous sedative drugs needed to produce a balanced sedation with the benefits of having reduced side-effects.

METHODS

Eighty-two patients requiring endoscopic and/or surgical procedures under conscious sedation and local anaesthesia were recruited for this pilot study. Conscious sedation was induced with a titrated dose of midazolam and propofol given intravenously until the clinical end-point of conscious sedation was achieved. Subsequently, during the procedure, the patient was asked to breathe sevoflurane 0.1-0.3% and a fixed ratio of 40% nitrous oxide in oxygen given through a face mask.

RESULTS

In 78 patients (95.1%), the treatment was completed successfully. Patients were discharged back to the wards within 4-16 min (10.1) without significant side-effects. Treatment was satisfactorily accepted by 38 patients (48.7%) and considered excellent by 40 patients (51.3%).

CONCLUSIONS

The use of titrated doses of intravenous sedative drugs for induction of conscious sedation followed by the use of low concentrations (0.1-0.3%) of sevoflurane combined with 40% nitrous oxide for maintenance of conscious sedation in patients requiring endoscopic and/or surgical procedures under local anaesthesia, has the potential advantages of reducing amounts of intravenous sedative drugs, less likelihood of problems from drug side-effects and fast recovery and discharge time. Further investigations to establish the technique are currently in progress.

Authors+Show Affiliations

University of Leeds, Academic Unit of Anaesthesia, St. James's University Hospital, Leeds, UK. delahoud@aol.comNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16895617

Citation

Lahoud, G Y., and P M. Hopkins. "Balanced Conscious Sedation With Intravenous Induction and Inhalational Maintenance for Patients Requiring Endoscopic And/or Surgical Procedures." European Journal of Anaesthesiology, vol. 24, no. 2, 2007, pp. 116-21.
Lahoud GY, Hopkins PM. Balanced conscious sedation with intravenous induction and inhalational maintenance for patients requiring endoscopic and/or surgical procedures. Eur J Anaesthesiol. 2007;24(2):116-21.
Lahoud, G. Y., & Hopkins, P. M. (2007). Balanced conscious sedation with intravenous induction and inhalational maintenance for patients requiring endoscopic and/or surgical procedures. European Journal of Anaesthesiology, 24(2), 116-21.
Lahoud GY, Hopkins PM. Balanced Conscious Sedation With Intravenous Induction and Inhalational Maintenance for Patients Requiring Endoscopic And/or Surgical Procedures. Eur J Anaesthesiol. 2007;24(2):116-21. PubMed PMID: 16895617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Balanced conscious sedation with intravenous induction and inhalational maintenance for patients requiring endoscopic and/or surgical procedures. AU - Lahoud,G Y, AU - Hopkins,P M, Y1 - 2006/08/08/ PY - 2006/06/26/accepted PY - 2006/8/10/pubmed PY - 2007/4/5/medline PY - 2006/8/10/entrez SP - 116 EP - 21 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 24 IS - 2 N2 - BACKGROUND AND OBJECTIVE: The use of inhalation sedation with sub-anaesthetic concentrations of sevoflurane and nitrous oxide mixture is expected to reduce amounts of intravenous sedative drugs needed to produce a balanced sedation with the benefits of having reduced side-effects. METHODS: Eighty-two patients requiring endoscopic and/or surgical procedures under conscious sedation and local anaesthesia were recruited for this pilot study. Conscious sedation was induced with a titrated dose of midazolam and propofol given intravenously until the clinical end-point of conscious sedation was achieved. Subsequently, during the procedure, the patient was asked to breathe sevoflurane 0.1-0.3% and a fixed ratio of 40% nitrous oxide in oxygen given through a face mask. RESULTS: In 78 patients (95.1%), the treatment was completed successfully. Patients were discharged back to the wards within 4-16 min (10.1) without significant side-effects. Treatment was satisfactorily accepted by 38 patients (48.7%) and considered excellent by 40 patients (51.3%). CONCLUSIONS: The use of titrated doses of intravenous sedative drugs for induction of conscious sedation followed by the use of low concentrations (0.1-0.3%) of sevoflurane combined with 40% nitrous oxide for maintenance of conscious sedation in patients requiring endoscopic and/or surgical procedures under local anaesthesia, has the potential advantages of reducing amounts of intravenous sedative drugs, less likelihood of problems from drug side-effects and fast recovery and discharge time. Further investigations to establish the technique are currently in progress. SN - 0265-0215 UR - https://www.unboundmedicine.com/medline/citation/16895617/Balanced_conscious_sedation_with_intravenous_induction_and_inhalational_maintenance_for_patients_requiring_endoscopic_and/or_surgical_procedures_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16895617.ui DB - PRIME DP - Unbound Medicine ER -