Reaction time‐monitored patient‐maintained propofol sedation: a pilot study in oral surgery patients

• Published in: Anaesthesia Vol. 68; no. 7; pp. 760 - 764
• Main Authors: O'Brien, C., Urquhart, C. S., Allam, S, Anderson, K. J., Leitch, J. A., Macpherson, A., Kenny, G. N. C.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.07.2013
• Subjects: Adult; Anesthesia; Blood Pressure - drug effects; Conscious Sedation - psychology; Feedback; Female; Half-Life; Heart Rate - drug effects; Humans; Hypnotics and Sedatives - pharmacokinetics; Male; Maxillofacial surgery; Monitoring, Intraoperative; Oral Surgical Procedures; Oxygen - blood; Patient Satisfaction; Pilot Projects; Propofol - pharmacokinetics; Reaction Time - drug effects; Respiratory Rate - drug effects
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.12291

Summary Previous volunteer studies of an effect‐site controlled patient‐maintained sedation system using propofol have demonstrated a risk of oversedation. We have incorporated a reaction time monitor into the handset to add an individualised patient‐feedback mechanism. This pilot study assessed if the reaction time‐feedback modification would prove safe and effective in 20 healthy patients receiving sedation while undergoing oral surgery. All patients successfully sedated themselves without reaching any unsafe endpoints. All 20 maintained verbal contact throughout. The mean (SD) lowest peripheral blood oxygen saturation was 98.0 (2.1)% breathing room air. No patient required supplementary oxygen. The mean (SD) maximum effect‐site propofol concentration reached was 1.6 (0.5) μg.ml−1. The present system was found to be safe and effective, allowing oral surgery treatment under conscious sedation, but preventing oversedation.