The Effective Effect-Site Propofol Concentration for Induction and Intubation with Two Pharmacokinetic Models in Morbidly Obese Patients Using Total Body Weight
dc.contributor.author | Echevarria, Ghislaine C. | |
dc.contributor.author | Elgueta, Maria F. | |
dc.contributor.author | Donoso, Maria T. | |
dc.contributor.author | Bugedo, Diego A. | |
dc.contributor.author | Cortinez, Luis I. | |
dc.contributor.author | Munoz, Hernan R. | |
dc.date.accessioned | 2024-01-10T12:43:40Z | |
dc.date.available | 2024-01-10T12:43:40Z | |
dc.date.issued | 2012 | |
dc.description.abstract | BACKGROUND: Most pharmacokinetic (PK) models used for propofol administration are based on studies in normal-weight patients. Extrapolation of these models for morbidly obese patients is controversial. Using 2 PK models and a target-controlled infusion system, we determined the predicted propofol effect-site concentration (Ce) needed for induction of anesthesia in morbidly obese subjects using total body weight. | |
dc.description.abstract | METHODS: Sixty-six morbidly obese subjects from 18 to 50 years of age were randomized to receive propofol to reach and maintain a predetermined propofol Ce, based on the PK models of either Marsh or Schnider. All patients were monitored with a Bispectral Index electroencephalographic monitor. Fentanyl 3 mu g/kg total body weight was administered before starting the propofol infusion. After loss of consciousness, vecuronium was, administered to facilitate endotracheal intubation. Groups of 6 patients each received propofol at a different, predetermined target propofol Ce. An "effective Ce" (ECe) was defined as the propofol Ce that provided adequate hypnosis (Bispectral Index <60) during the complete induction period (45 seconds after reaching the predetermined target Ce until 5 minutes after tracheal intubation). Heart rate and arterial blood pressure were measured every 1 minute throughout the study period. Probit regression analysis was performed to calculate the effective propofol Ce values to induce hypnosis in 50% (ECe50) and 95% (ECe95) of patients with 95% confidence intervals (CIs). | |
dc.description.abstract | RESULTS: Patient characteristics were similar between models and across the propofol target concentration groups. The ECe50 of propofol was 3.4 mu g/mL (95% CI: 2.9, 3.7 mu g/mL) with the Marsh model and 4.5 mu g/mL (95% CI: 4.1, 4.8 mu g/mL) with the Schnider model (P < 0.001). The ECe95 values were 4.2 mu g/mL (95% CI: 3.8, 6.2 mu g/mL) and 5.5 mu g/mL (95% CI: 5.0, 7.2 mu g/mL) with Marsh and Schnider models, respectively. At the ECe95, hemodynamic effects were similar with the 2 PK models. | |
dc.description.abstract | CONCLUSION: Different propofol target concentrations for each PK model must be used for induction when using total body weight in morbidly obese patients. (Anesth Analg 2012;115: 823-9) | |
dc.fechaingreso.objetodigital | 2024-05-15 | |
dc.format.extent | 7 páginas | |
dc.fuente.origen | WOS | |
dc.identifier.doi | 10.1213/ANE.0b013e31825d6254 | |
dc.identifier.issn | 0003-2999 | |
dc.identifier.pubmedid | MEDLINE:22956531 | |
dc.identifier.uri | https://doi.org/10.1213/ANE.0b013e31825d6254 | |
dc.identifier.uri | https://repositorio.uc.cl/handle/11534/77613 | |
dc.identifier.wosid | WOS:000309490500012 | |
dc.information.autoruc | Medicina;Cortinez L;S/I;79356 | |
dc.information.autoruc | Medicina;Donoso M;S/I;182413 | |
dc.information.autoruc | Medicina;Echevarria G;S/I;152736 | |
dc.information.autoruc | Medicina;Elgueta M;S/I;167324 | |
dc.information.autoruc | Medicina;Munoz H;S/I;73573 | |
dc.issue.numero | 4 | |
dc.language.iso | en | |
dc.nota.acceso | contenido parcial | |
dc.pagina.final | 829 | |
dc.pagina.inicio | 823 | |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | |
dc.revista | ANESTHESIA AND ANALGESIA | |
dc.rights | acceso restringido | |
dc.subject | INFUSION | |
dc.subject | ANESTHESIA | |
dc.subject | PHARMACODYNAMICS | |
dc.subject | CHILDREN | |
dc.subject | PLASMA | |
dc.title | The Effective Effect-Site Propofol Concentration for Induction and Intubation with Two Pharmacokinetic Models in Morbidly Obese Patients Using Total Body Weight | |
dc.type | artículo | |
dc.volumen | 115 | |
sipa.codpersvinculados | 79356 | |
sipa.codpersvinculados | 182413 | |
sipa.codpersvinculados | 152736 | |
sipa.codpersvinculados | 167324 | |
sipa.codpersvinculados | 73573 | |
sipa.index | WOS | |
sipa.index | Scopus | |
sipa.trazabilidad | Carga SIPA;09-01-2024 |
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