The combined use of propofol and fentanyl for outpatient intravenous conscious sedation

BACKGROUND. Intravenous conscious sedation is currently being widely utiliz ed for outpatient surgery including dermatologic surgery. Even though this type of anesthesia is typically administered by a trained licensed anesthet ist, it is important for dermatologists who either intend to or are current ly utilizing this type of anesthesia to be familiar with some of the method s and agents that are commonly employed. OBJECTIVE. Propofol and fentanyl are two anesthetic agents that are in prev alent use for skin and soft tissue surgery of brief or limited duration. Wi th the goal of familiarizing dermatologic surgeons with this form of anesth esia, a study was conducted to evaluate the safety and effectiveness of the combination of propofol and fentanyl when used for conscious sedation in a n outpatient dermatology center. METHODS. Twenty patients, ages 25-65 years, who required conscious sedation were enrolled. Each patient received a standard dosage of fentanyl and pro pofol, as determined on a kilogram basis. Sedation time, total procedure ti me, recovery time, and total propofol dose, along with side effects, were d etermined. RESULTS. The mean onset to sedation was 52.5 seconds, the mean procedure ti me was 40 minutes 37 seconds, and the mean interval to recovery was 3 minut es 43 seconds, with a mean total dose of propofol of 5.83 mg/kg. Minimal si de effects occurred. CONCLUSION. Propofol when used in conjunction with fentanyl appears to be a safe, quick, and effective method of providing conscious sedation.