New anesthetic programs for big elderly in day surgery

Abstract

Materials and methods A study was conducted in double-blind, random, with 86 patients subjected to two different regimens of sedation with midazolam and propofol, pain with remifentanil. Inclusion criteria: age> 70 years, body weight 69 ± 6 kg, informed consent MAC, ASA II-III stabilized cardiovascular and respiratory conditions (pO2 ≤70 and pCO2 <45 mmHg). Exclusion criteria: risk of bleeding, ASA III in acute, severe neurological disorders, severe hepatic dysfunction. During surgery, the monitoring of the level of sedation and mental status was performed comparing three methods of assessment: the clinical evaluation of drug effects on the CNS (Observer Assessment of Alertness/Sedation scale OAA/S), MAC has a sedation level of 3-4, the assessment of sedation according to Ramsay scale, and instrumental evaluation (Bispectral Index BIS). The clinical procedure was: O2 inhalation when the area was infiltrated with local anesthetic or BNP, when patients had pain a continuous infusion of remifentanil was activated: 0.025 to 0.05 mcgr/kg/m. Patients were dichotomized randomly into two groups with different sedation: group P (45 patients), starter bolus of 0.5 mg/kg propofol and continuous infusion of propofol 1-2 mg/kg/h; group M (41 patients), starter bolus of 0.03 to 0.05 mg/kg midazolam and then infusion of 1-2 μgr/kg/h. Tables 1 and 2.