Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | duminicŃ, 24 ianuarie 2021
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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Cristina Corneci (1) , Emanuela Ion (1), B. Stanescu (1), T. Horvat (2)
Universitatea de Medicina si Farmacie „Carol Davila”, Bucuresti, Romania
(1) Institutul Clinic de Endocrinologie „C.I. Parhon” Bucuresti
(2) Clinica de Chirurgie Toracica, Institutul Oncologic „Prof. Dr. Al. Trestioreanu” Bucuresti
Jurnalul de chirurgie (Ia┼či). 2013; 9(1): 53-61.
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AIM: This study aims to establish the effects of sedation monitored associated with local anesthesia in patient with secondary/tertiary hyperparathyroidism and evaluating the efficiency of two combinaton anesthetic,fentanyl-propofol and ketamine-midazolam. METHODS: We performed a retrospectiv study in the „C.I. Parhon” Clinical Institute of Endocrinology during 2000-2009 on 77 patients with secondary / tertiary hyperparathyroidism with age between 20 to 80 years, ASA III / IV, who received monitored sedation for total parathyroidectomy. Patients were divided into two groups: group A with combination fentanyl-propofol (n=52) and group B with ketamine-midazolam (n=25). Both groups were given as premedication with 0.03 mg/kgc midazolam. After local anesthesia with lidocaine for the patients in group A it was administred boluses of 0.15 mcg/kg fentanyl and 0.5 mg/kg propofol and, for the patients from group B, 0.4 mg/kg ketamine and 0.02mg/kg midazolam. Intraoperatively there were monitored heart rate, breathing rates, blood pressure average and haemoglobin saturation in oxigen. Hemodynamic stability, periods of desaturation, sedation and recovery time of consciousness and the surgeon and patient confort were recorded too. RESULTS: Intraoperatively, for both groups were obtained similar degrees of sedation (3 to 4 on Ramsay scale); several blood pressure changes have noted (9 patients (17.3%) with hypotension in group A vs 2 patients (8%) in group B). Bradycardia was noted in both groups: (9 patients (17.3%) in group A and 4 patients (16%) from group B) most likely due to hypercalcemia. Oxygen saturation decreased to a value of 85% for 3 patients (5.76%) from group A and 2 patients (8%) from group B. None of the patients required orotracheal intubation. In 8 patients (32%) from group B hallucinations were noted as drugs side effects. The recovery time was significantly longer in the group B (12±3 vs 5±1 minutes). There were no significant difference in terms of quality of anesthesia in the two groups appreciated as „very good” by the surgeons and patients. CONCLUSION: Monitored sedation with fentanyl-propofol or ketamine-midazolam potentiates the efect of topical anesthetics and would be considered as a good option for the parathyroid surgery.

HOW TO CITE: Corneci C, Ion E, Stanescu B, Horvat T. [Monitored sedation as an adjunct to local anesthesia in total parathyroidectomy]. Jurnalul de chirurgie (Iasi). 2013; 9(1): 53-61. DOI: 10.7438/1584-9341-9-1-7.

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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.