Abstract
Background: Although intravenous sedation is known for numerous benefits, thorough consideration and management are required for adverse effects and complications that may occur during the perioperative period. We herein report our experiences with patients who underwent intravenous sedation in our department, in addition to frequency and evaluation of adverse effects and complications in these patients.
Methods: From March 1997 to May 2004, intravenous sedation was used in 1938 patients in our department, with midazolam in 804 patients (group M) and propofol in 1134 patients (group P). By examining anesthesia and medical records for these patients, the nature and frequency of any adverse effects or complications during the perioperative period was investigated, and the 2 groups were comparatively evalauted.
Results: Patients with adverse effects or complications in each group are as follows. Blood pressure increased by 30% for 22 patients in group M and 18 patients in group P, and decreased by 30% for 19 patients in group M and 115 patients in group P. Heart rates increased by 30% for 26 patients in group M and 75 patients in group P, and decreased by 30% for 5 patients in group M and 16 patients in group P, while arrhythmia was noted in 8 patients of group M and 2 patients in group P. Respiratory depression was identified in 23 patients of group M and 49 patients in group P, and SpO2 was identified to be 93% for 30 patients in group M and 32 patients in group P. Nausea and vomiting was present in 12 patients of group M and 4 patients in group P, while discomfort was reported by 2 patients in group M and 1 patient in group P. Allergy-like reactions developed in 4 patients of group M and 2 patients in group P, while vaso-vagal reflex or neurogenic shock was noted in 2 patients of group M and 3 patients in group P. Shivering and tremor occurred in 1 patient of group M and 2 patients in group P, and symptoms of hyperventilation were observed in 1 patient from each group. Choking occurred in 9 patients, vascular pain developed in 217 patients and postoperative angina was identified in 1 patient from group P, but none of these conditions were noted in the patients in group M.
Discussion: Although adequate and favorable sedation was achieved with reduced frequency of nausea or vomiting in group P compared to group M, frequency of hypotension, tachycardia, vascular pain, respiratory depression and choking was identified to occur at higher frequencies and these adverse effects need to be thoroughly considered.
