» Articles » PMID: 16225721

Sedation with Target-controlled Propofol Infusion During Shoulder Surgery Under Interscalene Brachial Plexus Block in the Sitting Position: Report of a Series of 140 Patients

Overview
Specialty Anesthesiology
Date 2005 Oct 18
PMID 16225721
Citations 8
Authors
Affiliations
Soon will be listed here.
Abstract

Background And Objective: The aim of this study was to assess target-controlled propofol infusion as a technique of sedation for shoulder surgery under interscalene brachial plexus block in the sitting position and to evaluate the effect of sedation on hypotensive/bradycardic events during this procedure.

Methods: One hundred and forty patients undergoing elective shoulder surgery in the sitting position under interscalene brachial plexus block (with 30 mL of ropivacaine 0.75%) were prospectively enrolled. All patients were premedicated with hydroxyzine 1 mg kg(-1), none received beta-blockers. No patients were given atropine except for the patients who experienced a vasovagal event either during the block procedure or intravenous catheter placement. The target-controlled propofol infusion was started immediately after positioning the patient on the operating table. The initial target concentration was 1 microg mL(-1). The infusion rate was adjusted every 15 min by increasing or decreasing the target concentration by 0.2 microg mL(-1) steps to maintain the patient rousable to verbal commands (score of 3 on Wilson sedation scale). The following parameters were assessed: minimal, maximal, optimal target concentration, respiratory and haemodynamic parameters, total propofol dose, additional alfentanil needs, occurrence of hypotensive/bradycardic events, complications. Results are mean +/- SD. Statistical analysis used t-test and chi2-tests.

Results: The optimal propofol target concentration was 0.8 mug mL(-1). No respiratory complications or conversion to general anaesthesia was reported. Two patients experienced transient and inconsequential intraoperative agitation. The incidence of hypotensive/bradycardic events during the procedure was 5.7% (eight patients).

Conclusion: Target-controlled propofol infusion (0.8-0.9 microg mL(-1)) following hydroxyzine premedication is a safe and effective technique for sedation when combined with interscalene brachial plexus block during shoulder surgery in the sitting position.

Citing Articles

Anesthesia With Propofol Sedation Reduces Locoregional Recurrence in Patients With Breast Cancer Receiving Total Mastectomy Compared With Non-Propofol Anesthesia.

Zhang J, Chang C, Lu C, Chen H, Wu S Front Oncol. 2022; 12:708632.

PMID: 35311108 PMC: 8927654. DOI: 10.3389/fonc.2022.708632.


Adverse heart rate responses during beach-chair position for shoulder surgeries - A systematic review and meta-analysis of their incidence, interpretations and associations.

Tantry T, Karanth H, Koteshwar R, Shetty P, Adappa K, Shenoy S Indian J Anaesth. 2020; 64(8):653-667.

PMID: 32934399 PMC: 7457979. DOI: 10.4103/ija.IJA_228_20.


Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position.

Ryu T, Kim B, Woo S, Lee S, Lim J, Kwak S Korean J Anesthesiol. 2020; 73(6):542-549.

PMID: 32213804 PMC: 7714633. DOI: 10.4097/kja.20035.


Case of Vasovagal Syncope With Asystole Associated With Propofol Sedation.

Fujii-Abe K, Uriu K, Kawahara H Anesth Prog. 2015; 62(4):159-61.

PMID: 26650494 PMC: 4675341. DOI: 10.2344/13-00034.1.


Bispectral index-guided general anaesthesia in combination with interscalene block reduces desflurane consumption in arthroscopic shoulder surgery: a clinical comparison of bupivacaine versus levobupivacaine.

Ozturk L, Kesimci E, Albayrak T, Kanbak O BMC Anesthesiol. 2015; 15:104.

PMID: 26194656 PMC: 4508821. DOI: 10.1186/s12871-015-0087-8.