Affect of various sedation protocols and perioperative procedures on sufferers admitted to the intensive care unit after maxillofacial tumor surgical procedure of the decrease jaw: A retrospective research.
J Craniomaxillofac Surg. 2016 Apr;44(four):506-11
Authors: Lebherz-Eichinger D, Tudor B, Krenn CG, Roth GA, Seemann R
Maxillofacial tumor surgical procedure typically necessitates extended invasive air flow to forestall blockage of the respiratory tract. To tolerate air flow, constantly administered sedatives are really helpful. Half-time of sedative or analgesic treatment is a vital attribute by which narcotic medicine are chosen, on account of the truth that weaning interval will increase with half-time. The intention of our research was to analyze whether or not a change in sedation routine would have an effect on the size of invasive air flow or intensive care unit keep and medical prices. Moreover, the influence of varied surgical procedures was analyzed. Knowledge of 157 sufferers after mandibular surgical procedure had been retrospectively analyzed over 5 years in depend regression fashions. Of these sufferers, 84 obtained a sedation routine with sufentanil and midazolam and 73 with remifentanil and propofol. The influence of the surgical procedures (tracheostomy, tumor resection, neck dissection and size of operation) and the affected person age and intercourse had been analyzed with respect to size of air flow and ICU days. Value financial savings had been calculated. Our knowledge present that sufferers receiving remifentanil/propofol had fewer air flow days (2.5 ± 2.5 versus 6.1 ± four.6 days, P < zero.001) and had been discharged earlier from the intensive care unit than sufferers receiving sufentanil/midazolam (5.1 ± three.eight versus 9.2 ± 6.2 days, P < zero.001), resulting in calculated price financial savings of about 8000 Euro per affected person. Size of operation negatively influenced size of ICU keep (P < zero.001). In conclusion, short-acting medicine akin to remifentanil/propofol, in addition to tracheostoma and shortened surgical procedure length might cut back the postoperative want for invasive air flow and size of intensive care unit keep.
PMID: 26874556 [PubMed – indexed for MEDLINE]