Comparison of Efficacy of Propofol When Used with or without Remifentanil during Conscious Sedation with a Target-Controlled Infuser for Impacted Teeth Extraction
Sung Ju-Han, 김현정, 최윤지, 이수언, 서광석,
소속 상세정보
( Sung Ju-Han ) - Seoul National University School of Dentistry
김현정 ( Kim Hyun-Jeong ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
최윤지 ( Choi Yoon-Ji ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
이수언 ( Lee Soo-Eon ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
KMID : 0980220140140040213
Abstract
Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there
are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled
infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target
concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth.
Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was 1 μg/ml (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was 0.6 μg/ml and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared.
Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total
sedation time. However, total infused dose and the effect site target concentration of propofol was 163.8 ± 74.5 mg and 1.13 ± 0.21 μg/ml in group 1, and 104.3 ± 46.5 mg and 0.72 ± 0.26 μg/ml in the group 2 with 1.02 ± 0.21 ng/ml of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation.
Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.
키워드
Propofol; Remifentanil; Sedation; Target concentration; Target controlled infusion; Tooth extraction
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