Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study.
- Author:
Hyeonjung YEO
1
;
Wonwoo KIM
;
Hyochun PARK
;
Hoonnam KIM
Author Information
- Publication Type:Original Article
- Keywords: Conscious sedation; Deep sedation; Hypnotics and sedatives; Consciousness monitors
- MeSH: Alanine Transaminase; Alcohol Drinking; Aspartate Aminotransferases; Body Mass Index; Body Weight; Conscious Sedation*; Consciousness Monitors; Creatinine; Deep Sedation; Female; Glucose; Humans; Hypnotics and Sedatives; Ketamine; Midazolam; Plastics*; Prospective Studies*; Smoke; Smoking; Surgery, Plastic*
- From:Archives of Plastic Surgery 2017;44(1):5-11
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Conscious sedation has been widely utilized in plastic surgery. However, inadequate research has been published evaluating adequate drug dosage and depth of sedation. In clinical practice, sedation is often inadequate or accompanied by complications when sedatives are administered according to body weight alone. The purpose of this study was to identify variables influencing the depth of sedation during conscious sedation for plastic surgery. METHODS: This prospective study evaluated 97 patients who underwent plastic surgical procedures under conscious sedation. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and glucose levels were measured. Midazolam and ketamine were administered intravenously according to a preset protocol. Bispectral index (BIS) recordings were obtained to evaluate the depth of sedation 4, 10, 15, and 20 minutes after midazolam administration. Associations between variables and the BIS were assessed using multiple regression analysis. RESULTS: Alcohol intake and female sex were positively associated with the mean BIS (P<0.01). Age was negatively associated with the mean BIS (P<0.01). Body mass index (P=0.263), creatinine clearance (P=0.832), smoking history (P=0.398), glucose (P=0.718), AST (P=0.729), and ALT (P=0.423) were not associated with the BIS. CONCLUSIONS: Older patients tended to have a greater depth of sedation, whereas females and patients with greater alcohol intake had a shallower depth of sedation. Thus, precise dose adjustments of sedatives, accounting for not only weight but also age, sex, and alcohol consumption, are required to achieve safe, effective, and predictable conscious sedation.
