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Yeo H, Kim W, Park H, et al. Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study. Arch Plast Surg. 2017;44(1):5-11doi: 10.5999/aps.2017.44.1.5.
Yeo, H., Kim, W., Park, H., & Kim, H. (2017). Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study. Archives of plastic surgery, 44(1), 5-11. https://doi.org/10.5999/aps.2017.44.1.5
Yeo, Hyeonjung, et al. "Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study." Archives of plastic surgery vol. 44,1 (2017): 5-11. doi: https://doi.org/10.5999/aps.2017.44.1.5
Yeo H, Kim W, Park H, Kim H. Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study. Arch Plast Surg. 2017 Jan;44(1):5-11. doi: 10.5999/aps.2017.44.1.5. Epub 2017 Jan 20. PMID: 28194341; PMCID: PMC5300924.
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Arch Plast Surg. 2017 Jan;44(1):5-11. doi: 10.5999/aps.2017.44.1.5. Epub 2017 Jan 20.

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

Archives of plastic surgery

Hyeonjung Yeo, Wonwoo Kim, Hyochun Park, Hoonnam Kim

Affiliations

  1. Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea.

PMID: 28194341 PMCID: PMC5300924 DOI: 10.5999/aps.2017.44.1.5

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<0.01). Age was negatively associated with the mean BIS (P<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.

Keywords: Conscious sedation; Consciousness monitors; Deep sedation; Hypnotics and sedatives

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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