Hemodynamics in Elderly Coronary Artery Disease Patients Undergoing Propofol Sedation
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.
⁎Formerly, Chief Resident, Department of Oral and Maxillofacial Surgery, The University of Texas Southwestern Medical Center/Parkland Memorial Hospital, Dallas, TX; and Currently, Associate Professor, Department of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.
†Professor, Department of Surgery, Division of Oral and Maxillofacial Surgery and Department of Cell Biology, The University of Texas Southwestern Medical Center, and Chief, Oral and Maxillofacial Surgery, Veterans Administration North Texas Health Care System, Dallas, TX.
Address correspondence and reprint requests to Dr Cillo: Department of Oral and Maxillofacial Surgery, Allegheny General Hospital, 320 East North Avenue, Suite 0107, Pittsburgh, PA 15212
ABSTRACT