Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study

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 accordi...

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Published in:Archives of plastic surgery 2017, 44(1), , pp.5-11
Main Authors: Yeo, Hyeonjung, Kim, Wonwoo, Park, Hyochun, Kim, Hoonnam
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Language:English
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conscious sedation
consciousness monitors
deep sedation
hypnotics and sedatives
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성형외과학
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Kim, Wonwoo
Park, Hyochun
Kim, Hoonnam
description 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
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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&lt;0.01). Age was negatively associated with the mean BIS (P&lt;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.</description><identifier>ISSN: 2234-6163</identifier><identifier>EISSN: 2234-6171</identifier><identifier>DOI: 10.5999/aps.2017.44.1.5</identifier><identifier>PMID: 28194341</identifier><language>eng</language><publisher>333 Seventh Avenue, 18th Floor, New York, NY 10001, USA: Thieme Medical Publishers, Inc</publisher><subject>conscious sedation ; consciousness monitors ; deep sedation ; hypnotics and sedatives ; Original ; Original Article ; 성형외과학</subject><ispartof>Archives of Plastic Surgery, 2017, 44(1), , pp.5-11</ispartof><rights>The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. 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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&lt;0.01). Age was negatively associated with the mean BIS (P&lt;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.</description><subject>conscious sedation</subject><subject>consciousness monitors</subject><subject>deep sedation</subject><subject>hypnotics and sedatives</subject><subject>Original</subject><subject>Original Article</subject><subject>성형외과학</subject><issn>2234-6163</issn><issn>2234-6171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk1vEzEQhlcIRKvQMzfkIxyytddfuxyQovAVqRIVKdyQ5bVnE6cbO9i7lfLvcZIS0QO-jGU_ft_xzBTFa4JL3jTNtd6lssJEloyVpOTPisuqomwqiCTPz3tBL4qrlDY4L4G54ORlcVHVpGGUkcvi108dnW57SGjhu34Eb5xfoWEN6CPshjUKHZoHn4wLY0JLsHpwwSPn0W2v0-AMWo5xBXH_Hs3QbQxpB2ZwD4CWw2j3r4oXne4TXD3GSfHj86e7-dfpzbcvi_nsZmo4rYZpAxIYp7SCjlGpdWssbzghjFopKNei6owVhGhpaGepramWWrK26loiQVI6Kd6ddH3s1L1xKmh3jKug7qOafb9bKEKJwBXO7OLE2qA3ahfdVsf98cHxIMSV0jF_rAclW24lFnUncrm0MQ2ROKeDCZbEGHvw_XDS2o3tFqwBP0TdPxF9euPdOuf0oDjFuKlYFnj7KBDD7xHSoLYuGeh77SEXXJFa1LQRuK4zen1CTa5yitCdbQhWh3lQeR7UYR4UY4pki0nx5t_szvzf7megPAHD2sEW1CaM0ec-_VfxD2g4wAU</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Yeo, Hyeonjung</creator><creator>Kim, Wonwoo</creator><creator>Park, Hyochun</creator><creator>Kim, Hoonnam</creator><general>Thieme Medical Publishers, Inc</general><general>The Korean Society of Plastic and Reconstructive Surgeons</general><general>대한성형외과학회</general><scope>0U6</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>ACYCR</scope></search><sort><creationdate>201701</creationdate><title>Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study</title><author>Yeo, Hyeonjung ; Kim, Wonwoo ; Park, Hyochun ; Kim, Hoonnam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-9e7e45332ef437aabcd5951143d7635a62fcd611a7c3fd3d83a7a74b2fb17e733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>conscious sedation</topic><topic>consciousness monitors</topic><topic>deep sedation</topic><topic>hypnotics and sedatives</topic><topic>Original</topic><topic>Original Article</topic><topic>성형외과학</topic><toplevel>online_resources</toplevel><creatorcontrib>Yeo, Hyeonjung</creatorcontrib><creatorcontrib>Kim, Wonwoo</creatorcontrib><creatorcontrib>Park, Hyochun</creatorcontrib><creatorcontrib>Kim, Hoonnam</creatorcontrib><collection>Open Access: Thieme Open Access Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>Korean Citation Index</collection><jtitle>Archives of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeo, Hyeonjung</au><au>Kim, Wonwoo</au><au>Park, Hyochun</au><au>Kim, Hoonnam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study</atitle><jtitle>Archives of plastic surgery</jtitle><addtitle>Arch Plast Surg</addtitle><date>2017-01</date><risdate>2017</risdate><volume>44</volume><issue>1</issue><spage>5</spage><epage>11</epage><pages>5-11</pages><issn>2234-6163</issn><eissn>2234-6171</eissn><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&lt;0.01). Age was negatively associated with the mean BIS (P&lt;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.</abstract><cop>333 Seventh Avenue, 18th Floor, New York, NY 10001, USA</cop><pub>Thieme Medical Publishers, Inc</pub><pmid>28194341</pmid><doi>10.5999/aps.2017.44.1.5</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects conscious sedation
consciousness monitors
deep sedation
hypnotics and sedatives
Original
Original Article
성형외과학
title Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study
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