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Propofol patient-controlled sedation during hip or knee arthroplasty in elderly patients.
Can J Anaesth. 1997 Apr; 44(4):385-9.CJ

Abstract

PURPOSE

Little information is available regarding the use of patient-controlled sedation (PCS) among the elderly. This study evaluated the safety and efficacy of propofol PCS among elderly patients undergoing hip or knee arthroplasty.

METHODS

Forty patients, aged 65-78 yr, undergoing hip or knee arthroplasty under regional anaesthesia were randomized to receive propofol PCS (dose = 0.3 mg.kg-1, delay = three min; n = 20) or anaesthetist-administered midazolam-fentanyl sedation (n = 20). Sedation, anxiety and discomfort visual analogue scores (VAS) were measured, by an independent observer, preoperatively, immediately at the end of surgery and one hour following admission to the postanaesthetic care unit (PACU). Cognition was evaluated, using an abbreviated Mini Mental Status Examination, preoperatively and in the PACU. Patient satisfaction, based on VAS and a brief questionnaire, was measured in the PACU. The incidence of intraoperative complications was also compared.

RESULTS

Patient satisfaction was high in each group. Sedation and anxiety VAS were similar in each group. A high incidence of pain with drug injection was noted among patients receiving propofol (80%). Transient deeper levels of sedation (6 vs 1; P = 0.05) were observed more commonly in the propofol PCS group.

CONCLUSION

Propofol PCS provides effective sedation. Using a propofol dose of 0.3 mg.kg-1, transient episodes of deeper sedation were noted more frequently among patients receiving PCS. These episodes did not require intervention but, suggest that this propofol PCS dose approaches the limit of safety and should be further reduced for some elderly patients.

Authors+Show Affiliations

Department of Anaesthesia, University of Western Ontario, St. Joseph's Health Centre, London, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9104520

Citation

Ganapathy, S, et al. "Propofol Patient-controlled Sedation During Hip or Knee Arthroplasty in Elderly Patients." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 44, no. 4, 1997, pp. 385-9.
Ganapathy S, Herrick IA, Gelb AW, et al. Propofol patient-controlled sedation during hip or knee arthroplasty in elderly patients. Can J Anaesth. 1997;44(4):385-9.
Ganapathy, S., Herrick, I. A., Gelb, A. W., & Kirkby, J. (1997). Propofol patient-controlled sedation during hip or knee arthroplasty in elderly patients. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 44(4), 385-9.
Ganapathy S, et al. Propofol Patient-controlled Sedation During Hip or Knee Arthroplasty in Elderly Patients. Can J Anaesth. 1997;44(4):385-9. PubMed PMID: 9104520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Propofol patient-controlled sedation during hip or knee arthroplasty in elderly patients. AU - Ganapathy,S, AU - Herrick,I A, AU - Gelb,A W, AU - Kirkby,J, PY - 1997/4/1/pubmed PY - 1997/4/1/medline PY - 1997/4/1/entrez SP - 385 EP - 9 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 44 IS - 4 N2 - PURPOSE: Little information is available regarding the use of patient-controlled sedation (PCS) among the elderly. This study evaluated the safety and efficacy of propofol PCS among elderly patients undergoing hip or knee arthroplasty. METHODS: Forty patients, aged 65-78 yr, undergoing hip or knee arthroplasty under regional anaesthesia were randomized to receive propofol PCS (dose = 0.3 mg.kg-1, delay = three min; n = 20) or anaesthetist-administered midazolam-fentanyl sedation (n = 20). Sedation, anxiety and discomfort visual analogue scores (VAS) were measured, by an independent observer, preoperatively, immediately at the end of surgery and one hour following admission to the postanaesthetic care unit (PACU). Cognition was evaluated, using an abbreviated Mini Mental Status Examination, preoperatively and in the PACU. Patient satisfaction, based on VAS and a brief questionnaire, was measured in the PACU. The incidence of intraoperative complications was also compared. RESULTS: Patient satisfaction was high in each group. Sedation and anxiety VAS were similar in each group. A high incidence of pain with drug injection was noted among patients receiving propofol (80%). Transient deeper levels of sedation (6 vs 1; P = 0.05) were observed more commonly in the propofol PCS group. CONCLUSION: Propofol PCS provides effective sedation. Using a propofol dose of 0.3 mg.kg-1, transient episodes of deeper sedation were noted more frequently among patients receiving PCS. These episodes did not require intervention but, suggest that this propofol PCS dose approaches the limit of safety and should be further reduced for some elderly patients. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/9104520/Propofol_patient_controlled_sedation_during_hip_or_knee_arthroplasty_in_elderly_patients_ L2 - https://doi.org/10.1007/BF03014458 DB - PRIME DP - Unbound Medicine ER -