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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.

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Authors+Show Affiliations

Lahoud GY
University of Leeds, Academic Unit of Anaesthesia, St. James's University Hospital, Leeds, UK. delahoud@aol.com
Hopkins PM
No affiliation info available

MeSH

Administration, InhalationAdolescentAdultAgedAged, 80 and overAnesthesia, LocalAnesthetics, InhalationAnesthetics, IntravenousConscious SedationEndoscopyFeasibility StudiesFemaleHumansInfusions, IntravenousLength of StayMaleMethyl EthersMidazolamMiddle AgedNitrous OxidePatient SatisfactionPilot ProjectsPropofolSevofluraneSurgical Procedures, OperativeTreatment Outcome

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 -