Conscious Sedation by Propofol TCi for Corrective Surgery of a Mandibular Fracture

Abstract

Background: Infusion of propofol by a target-controlled infusion (TCI) system is effective in achieving conscious sedation for anxious patients presenting for dental surgery. However, there is no report of conscious sedation for mandibular fracture patients using propofol TCI. The objective of this study was to evaluate the appropriation of a conscious sedation using propofol for mandibular fracture patients. Methods: Twenty patients with a mandibular fracture undergoing an open reduction and miniplate insertion operation were analyzed. We anesthetized patients using a propofol infusion by a TCI system (Diprifusor: Master TCI: Pilot Anesthesia Is, France) with local anesthesia using lidocaine. The BIS score was evaluated continually during surgery using a microcomputer (A-2000 BIS monitor, Aspect Medical System, USA). We set the infusion machine at a target concentration 2/ml, and adjusted the propofol concentration for a BIS score range of 80-85. Infusion rate, total dosage, duration of induction, recall of operative procedure and cooperation scores were checked. BIS, heart rate, noninvasive arterial blood pressure, and were recorded during the operation. Results: The mean BIS score was 82.95, the mean target concentration of propofol was 2.645/ml, the mean infusion rate was 136.3/kg/min, and the mean cooperation score was 2.5, the patients were cooperative. The score of amnesia was 0.2, almost patients did not recall the intraoperative event. The mean duration of stay in the recovery room was 22.2 minutes, and the most frequent side effect was pain on injecion of propofol. Conclusions: Conscious sedation with propofol TCI is an effective anesthesia method substitute for general anesthesia with quick emergence, few side effects, and safety for mandibular fracture patients.