Joseph E Cillo1, Richard Finn. 1. Department of Oral and Maxillofacial Surgery, The University of Texas Southwestern Medical Center/Parkland Memorial Hospital, Dallas, TX, USA. jecdna@aol.com
Abstract
PURPOSE: The purpose of this study was to evaluate noninvasive intraoperative hemodynamics in an elderly population with coronary artery disease (CAD) undergoing midazolam/fentanyl intravenous sedation-analgesia, with or without propofol for dentoalveolar surgery. PATIENTS AND METHODS: A retrospective chart analysis of 24 consecutive male patients aged 60 years or greater, with coronary artery disease, undergoing midazolam/fentanyl intravenous sedation-analgesia with or without propofol for dentoalveolar surgery. Data recorded included noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and pulse (P). RESULTS: The addition of propofol to elderly CAD patients resulted in statistically significant lower averages for SBP (126.1 mm Hg vs 131.3 mm Hg, P < .01), DBP (64.1 mm Hg vs 74.3 mm Hg, P < .001), MAP (84.3 mm Hg vs 94.2 mm Hg, P < .001) and PP (57.7 mm Hg vs 61.8 mm Hg, P = .01) with statistically insignificant differences in pulse (74.2 beats per minute vs 75.8 beats per minute, P = .1). Baseline changes in elderly CAD patients who received propofol were within +/-20% (range: -13.8% to +6.9%). CONCLUSION: Midazolam/fentanyl intravenous sedation provided stable intraoperative hemodynamics in elderly CAD patients. The addition of propofol to elderly CAD patients also resulted in stable intraoperative hemodynamics and may be a safe adjunct to intravenous sedation in elderly CAD patients.
PURPOSE: The purpose of this study was to evaluate noninvasive intraoperative hemodynamics in an elderly population with coronary artery disease (CAD) undergoing midazolam/fentanyl intravenous sedation-analgesia, with or without propofol for dentoalveolar surgery. PATIENTS AND METHODS: A retrospective chart analysis of 24 consecutive male patients aged 60 years or greater, with coronary artery disease, undergoing midazolam/fentanyl intravenous sedation-analgesia with or without propofol for dentoalveolar surgery. Data recorded included noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and pulse (P). RESULTS: The addition of propofol to elderly CAD patients resulted in statistically significant lower averages for SBP (126.1 mm Hg vs 131.3 mm Hg, P < .01), DBP (64.1 mm Hg vs 74.3 mm Hg, P < .001), MAP (84.3 mm Hg vs 94.2 mm Hg, P < .001) and PP (57.7 mm Hg vs 61.8 mm Hg, P = .01) with statistically insignificant differences in pulse (74.2 beats per minute vs 75.8 beats per minute, P = .1). Baseline changes in elderly CAD patients who received propofol were within +/-20% (range: -13.8% to +6.9%). CONCLUSION:Midazolam/fentanyl intravenous sedation provided stable intraoperative hemodynamics in elderly CAD patients. The addition of propofol to elderly CAD patients also resulted in stable intraoperative hemodynamics and may be a safe adjunct to intravenous sedation in elderly CAD patients.