Comparison of efficacy of different sedation depths of monitored anesthesia care in vitrectomy / 中华麻醉学杂志

ABSTRACT

Objective To compare the efficacy of different sedation depths of monitored anesthesia care (MAC) in vitrectomy.Methods Ninety-six patients of both sexes,aged 40-64 yr,with body mass index ≤ 35 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective vitrectomy,were randomly divided into 2 groups (n =48 each) using a random number tablemild sedation group (group Ⅰ) and profound sedation group (group Ⅱ).Anesthesia was induced with iv midazolam 0.02 mg/kg and sufentanil 0.15 μg/kg.Anesthesia was maintained with iv infusion of propofol 0.5-2.0 mg · kg-1 · h-1 maintaining bispectral index (BIS) value＞80 in group Ⅰ,or with iv infusion of propofol 2-6 mg · kg-1 · h-1 maintaining BIS value at 65-80 in group Ⅱ.The occurrence of unexpected head movement,SPO2＜90％,snoring,and oculocardiac reflex during the procedure,postoperative nausea and vomiting,and the time when the patients in supine position were turned to prone position were recorded after surgery.Results Compared with group Ⅰ,the incidence of unexpected head movement,SpO2 ＜90％,and snoring was significantly increased,and the time when the patients in supine position were turned to prone position was prolonged (P＜0.05),and no significant difference was found in the incidence of postoperative nausea and vomiting and oculocardiac reflex during the procedure in group Ⅱ (P＞0.05).Conclusion Mild sedation of MAC (BIS value ≥ 80) provides better efficacy than profound sedation (BIS value 65-80) when used for vitrectomy.