Abeles G, Sequeira M, Swensen R D, Bisaccia E, Scarborough D A
Wright State University, Dayton, Ohio, USA.
Dermatol Surg. 1999 Jul;25(7):559-62. doi: 10.1046/j.1524-4725.1999.98225.x.
Intravenous conscious sedation is currently being widely utilized for outpatient surgery including dermatologic surgery. Even though this type of anesthesia is typically administered by a trained, licensed anesthetist, it is important for dermatologists who either intend to or are currently utilizing this type of anesthesia to be familiar with some of the methods and agents that are commonly employed.
Propofol and fentanyl are two anesthetic agents that are in prevalent use for skin and soft tissue surgery of brief or limited duration. With the goal of familiarizing dermatologic surgeons with this form of anesthesia, a study was conducted to evaluate the safety and effectiveness of the combination of propofol and fentanyl when used for conscious sedation in an outpatient dermatology center.
Twenty patients, ages 25-65 years, who required conscious sedation were enrolled. Each patient received a standard dosage of fentanyl and propofol, as determined on a kilogram basis. Sedation time, total procedure time, recovery time, and total propofol dose, along with side effects, were determined.
The mean onset to sedation was 52.5 seconds, the mean procedure time was 40 minutes 37 seconds, and the mean interval to recovery was 3 minutes 43 seconds, with a mean total dose of propofol of 5.83 mg/kg. Minimal side effects occurred.
Propofol when used in conjunction with fentanyl appears to be a safe, quick, and effective method of providing conscious sedation.
静脉清醒镇静目前广泛应用于包括皮肤科手术在内的门诊手术。尽管这类麻醉通常由经过培训的持牌麻醉师实施,但对于打算或正在使用这类麻醉的皮肤科医生来说,熟悉一些常用的方法和药物很重要。
丙泊酚和芬太尼是两种常用于短期或有限时长皮肤和软组织手术的麻醉剂。为使皮肤科外科医生熟悉这种麻醉方式,开展了一项研究,以评估丙泊酚和芬太尼联合用于门诊皮肤科中心清醒镇静时的安全性和有效性。
招募了20名年龄在25至65岁之间需要清醒镇静的患者。每位患者均接受基于千克体重确定的标准剂量的芬太尼和丙泊酚。测定了镇静时间、总手术时间、恢复时间、丙泊酚总剂量以及副作用。
平均镇静起效时间为52.5秒,平均手术时间为40分37秒,平均恢复间隔为3分43秒,丙泊酚平均总剂量为5.83mg/kg。副作用极少。
丙泊酚与芬太尼联合使用似乎是一种安全、快速且有效的清醒镇静方法。