Evaluation of patient-controlled sedation (PCS) during surgical removal of impacted lower third molars.
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Abstract
Objectives: The current study was conducted to evaluate the safety of patient-controlled sedation (PCS) and the efficiency of elastomeric infusion device during surgical removal of impacted lower third molars and its impact on patients regarding level of sedation, patients’ satisfaction and psycho-motor recovery.
Materials and methods:Twenty patients were equally divided into two groups chosen randomly. In both groups, 0.03 mg/kg Midazolam and 0.5 mg/kg Propofol were administered IV as a bolus dose. Group 1 was then given 0.3 mg/kg/hr Ketamine and 1.2 mg/kg/hr Propofol as a maintenance dose delivered through the PCS pump. Group 2 was then given 0.3 µg/kg/hr Fentanyl and 1.2 mg/kg/hr Propofol as a maintenance dose delivered through the PCS pump. For all patients’ surgical procedure were done under local anesthesia. Before going to the operating theatre all patients were instructed about the PCS pump and familiarized with it. Patients in both groups were evaluated for hemodynamic stability, patient's &surgeon's satisfaction, psychomotor recovery and adverse effects.
Results: The results of this study showed no statistical difference between the two groups. The use of different drug combinations in both groups showed hemodynamic stability, patients’& surgeon's satisfaction and rapid psychomotor recovery. None of the patients in both groups suffered from any adverse reactions such as: nausea, vomiting, hallucinations, involuntary movements, or over-sedation.
Conclusion: PCS can be considered as a safe option in minor oral surgeries providing the majority of patients with high satisfaction and relaxation, also providing the surgeons with good operating conditions and the cooperation of the majority of the patients. Fentanyl-Propofol and Ketamine-Propofol combinations were both safe with respect to hemodynamic changes with rapid recovery of psychomotor functions in all patients.
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