{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:35:05Z","timestamp":1788230105566,"version":"build-2803163510"},"reference-count":59,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011892","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG8K1331"],"award-info":[{"award-number":["CMRPG8K1331"]}],"id":[{"id":"10.13039\/501100011892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Supermicrosurgical lymphaticovenous anastomosis (LVA) is a minimally invasive surgical technique that creates bypasses between lymphatic vessels and veins, thereby improving lymphatic drainage and reducing lymphedema. This retrospective single-center study included 137 patients who underwent non-intubated LVA in southern Taiwan. A total of 119 patients were enrolled and assigned to two study groups: the geriatric (age \u2265 75 years, n = 23) and non-geriatric groups (age &lt; 75 years, n = 96). The primary outcome was to investigate and compare the arousal and maintenance of the propofol effect-site concentration (Ce) using an electroencephalographic density spectral array (EEG DSA) in both groups. The results showed that the geriatric group required less propofol (4.05 [3.73\u20134.77] mg\/kg\/h vs. 5.01 [4.34\u20135.92] mg\/kg\/h, p = 0.001) and alfentanil (4.67 [2.53\u20135.82] \u03bcg\/kg\/h vs. 6.68 [3.85\u20138.77] \u03bcg\/kg\/h, p = 0.047). The median arousal Ce of propofol among the geriatric group (0.6 [0.5\u20130.7] \u03bcg\/mL) was significantly lower than that in patients aged \u2264 54 years (1.3 [1.2\u20131.4] \u03bcg\/mL, p &lt; 0.001), 55\u201364 years (0.9 [0.8\u20131.0] \u03bcg\/mL, p &lt; 0.001), and &lt;75 years (0.9 [0.8\u20131.2] \u03bcg\/mL, p &lt; 0.001). In summary, the combined use of EEG DSA provides the objective and depth of adequate sedation for extensive non-intubated anesthesia in late-elderly patients who undergo LVA without perioperative complications.<\/jats:p>","DOI":"10.3390\/bioengineering10040494","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T02:05:31Z","timestamp":1682042731000},"page":"494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Density Spectral Array Enables Precise Sedation Control for Supermicrosurgical Lymphaticovenous Anastomosis: A Retrospective Observational Cohort Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-571X","authenticated-orcid":false,"given":"En-Bo","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Hsuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5783-1003","authenticated-orcid":false,"given":"Johnson Chia-Shen","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiung-Wen","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Jen-Ai Hospital, Taichung 412, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-7322","authenticated-orcid":false,"given":"Jo-Chi","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Park One International Hospital, Kaohsiung 813, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0984-6921","authenticated-orcid":false,"given":"Shao-Chun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, October 01). 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