ArticleBritish journal of anaesthesia2025
Psychomotor Responses to Independent Visual, Auditory and Tactile Electrical stimuli during Sevoflurane sedation (PRIVATES).
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundPatient-controlled sedation has potential benefits, including rapid recovery and improved patient satisfaction. During patient-controlled sedation, the recipient presses a button to self-administer the sedative. The safety and efficacy of this method is dependent upon the dose relationships between the sedative's desired effects, its impact on the ability to press a button, and adverse effect occurrence. This study aimed to investigate the relationship between sedation, psychomotor function, and adverse effect occurrence during clinician-controlled sevoflurane sedation.
methods15 healthy participants (10 males) were administered a sevoflurane dose-escalation protocol starting at 0 kPa and increasing in 0.2 kPa increments until a protocol endpoint occurred. Sevoflurane was delivered using conventional anaesthetic apparatus. At each sevoflurane dose, Richmond Agitation-Sedation Scale (RASS) and psychomotor function were assessed. Protocol endpoints included airway, respiratory, or cardiovascular compromise; agitation (RASS ≥+2); and sedation >3 h.
resultsThe protocol endpoint was sedation >3 h for nine (60%) participants, agitation for five (33%) participants, and tonic movements for one (7%) participant. The median [range] sevoflurane dose was 0.4 [0.2-1.0] kPa when RASS <0 (sedation dose), 1.2 [0.6-2.0] kPa when participants were unable to complete reaction time testing (button-press dose), and 1.6 [1.2-2.2] kPa at the protocol endpoint (endpoint dose). The sedation dose was less than the button-press dose (P<0.0001), and the button-press dose was less than the endpoint dose (P=0.002).
conclusionsPatient-controlled sevoflurane sedation is potentially feasible in a healthy population within the dose range 0.4-1.2 kPa. Concurrent reaction time monitoring could minimise the risk of agitation.
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