OBJECTIVE: To compare the sedation and analgesic effects between propofol-hydromorphone and propofol-dexmedetomidine in patients with postoperative intubation after maxillofacial plastic surgery. METHODS: Forty-two patients undertaking maxillofacial plastic surgery with intubation were randomly assigned into propofol plus hydromorphone (P-H) group or propofol plus dexmedetomidine (P-D) group, receiving intravenous infusion of P-H or P-D, respectively. Cerebral state index, Ramsay sedation score, arterial blood gas analysis, and physiology indices were recorded before admission (T0), 30 minutes (T1), 1 hour (T2), 2 hours (T3), 6 hours (T4), and 12 hours after admission (T5) to intensive care unit, and 10 minutes after extubation (T6). Blood interleukin-6 was measured with enzyme-linked immunosorbent assay. RESULTS: There was no significant difference in arterial blood gas analysis, oxygen saturation, mean arterial pressure, and respiratory rate between two groups at all time-points (P>0.05). The changes of heart rate (at T4, T5, and T6), cerebral state index (T1, T2, T3, T4, and T5), and Ramsay score (at T3) in P-H group were significantly different from that in P-D group (P<0.05). The plasma interleukin-6 at T4 in P-H group was significantly lower than that in P-D group (P<0.05). CONCLUSION: The P-H approach takes advantages over P-D approach in relieving the pain and discomfort, reducing the overstimulation of sympathetic nerve and the stress level, and enhancing the tolerance of postoperative intubation after maxillofacial plastic surgery.
BACKGROUND: The pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender. The purpose of this study was to compare effect-site half maximal effective concentrations (EC50) of propofol in male and female patients during i-gel insertion withdexmedetomidine 0.5 μg/kg without muscle relaxants.
CONCLUSIONS: During i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxant, male patients had higher effect-site EC50 forpropofol using Schnider's model. Based on the results of this study, patient gender should be considered when determining the optimal dose of propofol during supraglottic airway insertion.