Patient controlled sedation as coadjuvant for local or regional anesthesia
Orozco Vinasco, Adriana.*  Monzón Rubio, Eva.* Paniagua Montes, M. Amparo.* Cucchi, Cinzia.* Merino Estrada, Paula.* Nieto Martín, Noemí.*
Patient controlled sedation (PCS) allows the patient  to administer medication according to their individual needs, and offers a sense of control of the situation. We evaluate the overall satisfaction among  patients and anesthesiologists.
Matherial and Methods: data were collected by convenience, after patients consent was given.  We recorded data of 19 patients (n=19). CADD- Solis® PCA pump  (Smiths Medical) were used. The program designed was: 40 mg Propofol 1% every five minutes as much times as required. We assessed minimum SpO2, minimum BIS, adverse effects, boluses requested and boluses given, grade of sedation achieved, satisfaction of the patient and the anesthesiologist using a visual analogue scale from 1 to 5, being 1 no satisfaction at all and 5 highest satisfaction
Results: SpO2 remained stable, with a minimum SpO2 of 94% in one patient. The average number of doses requested was 18, 9 and the average number of doses given was 4,4. The sedation was reconverted in general anesthesia in 1 case, due to lack of collaboration of the patient. Grade III of sedation (sleepy, responds to commands) was achieved in 42% of the patients, 21% experienced pain at infusion. BIS minimum average obtained was 69,8. Average satisfaction among anesthesiologist was 4,4 and average satisfaction among patients was 4,8 (obtained at time of discharge of our unit). ETCO2 was monitored, no  apnoeas were reported.
Conclusion: PCS remains as a safe alternative to traditional sedation, with a high satisfaction among  patients and anesthesiologists.  Randomized controlled trials are needed to confirm these findings.
*Department of Anaesthesiology, Tajo´s Universitary Hospital, Aranjuez, Spain