Effects of Earmuffs and Eye Masks on Propofol Sedation during Spinal Anesthesia for Orthopedic Surgery: A Randomized Controlled Trial

Abstract

Intravenous sedative drugs are commonly administered during regional anesthesia. However, reducing the excessive use of sedatives while providing adequate sedation is important from the clinical perspective, since the use of sedatives can cause considerable complications. We hypothesized that the application of earmuffs and eye masks would help reduce the sedative dose required to maintain proper sedation by blocking external stimuli. Patients who underwent orthopedic surgery under spinal anesthesia were randomly allocated to the control (no intervention) or intervention group (wearing earmuffs and eye masks). Intravenous sedation was administered using target-controlled infusion of propofol. The target concentration was controlled to maintain a Modified Observer’s Assessment of Alertness and Sedation score of 3 or 4. The primary outcome was the intraoperative propofol requirement. We also investigated the incidence of apnea, and patient satisfaction. Propofol requirement was significantly lower in the intervention group than that in the control group (2.3 (2.0–2.7) vs. 3.1 (2.7–3.4) mg·kg−1·h−1; p < 0.001). Intraoperative apnea occurred less frequently (p = 0.038) and patient satisfaction was higher (p = 0.002) in the intervention group compared to the control group. This study demonstrated that the use of earmuffs and eye masks during sedation was associated with lower propofol requirement and improved sedation quality. © 2023 by the authors.