Predicted effect-site concentration of propofol and sufentanil for gynecological laparoscopic surgery

Title
Predicted effect-site concentration of propofol and sufentanil for gynecological laparoscopic surgery
Author(s)
정성미Kwon, H. U.[Kwon, H. U.]Yang, C. W.[Yang, C. W.]Oh, J-Y[Oh, J-Y]Cho, C. K[Cho, C. K]Kang, P. S.[Kang, P. S.]Lim, Y. S[Lim, Y. S]Jeong, S-J.[Jeong, S-J.]
Keywords
TARGET-CONTROLLED INFUSIONS; BISPECTRAL INDEX; NITROUS-OXIDE; PHARMACOKINETIC MODELS; ANESTHESIA; RECOVERY; REMIFENTANIL; FENTANYL; PHARMACODYNAMICS; CHOLECYSTECTOMY
Issue Date
201101
Publisher
WILEY-BLACKWELL PUBLISHING, INC
Citation
ACTA ANAESTHESIOLOGICA SCANDINAVICA, v.55, no.1, pp.110 - 117
Abstract
Background This study was to estimate the predicted effect-site concentration of propofol administered by a target-controlled infusion (TCI) for maintenance of anesthesia based on the bispectral (BIS) index as a measure of hypnosis in laparoscopic surgery. Method One-hundred and sixty unpremedicated patients undergoing gynecologic laparoscopy were assigned randomly to receive one of the target effect-site concentrations of propofol 2.0, 2.5, 3.0, 3.5 and 4.0 mu g/ml during TCI with propofol and sufentanil. The dose-response relationship of propofol for the maintenance of adequate anesthesia based on BIS, movement and hemodynamic response was investigated using a fixed effect-site concentration of sufentanil (0.2 ng/ml). The BIS values, hemodynamic variables, time course during emergence and intraoperative awareness were also assessed. Results The predicted effect-site propofol concentrations for adequate anesthesia at the skin incision in 50% (EC(50)) and 95% (EC(95)) of patients undergoing gynecologic laparoscopy were 2.2 and 3.7 mu g/ml, respectively. The predicted propofol EC(50) and EC(95) to maintain adequate anesthesia in these patients were 2.6 mu g/ml (95% CI 2.3-2.7 mu g/ml) and 3.6 mu g/ml (95% CI 3.3-4.0 mu g/ml), respectively. The BIS values, effect-site concentration of propofol, hemodynamic data and time course during emergence and post-operative adverse events were comparable in each group. There were no reports of intraoperative awareness in the post-anesthetic care unit. Conclusion Based on the anesthetic depth assessed by the clinical signs and BIS monitoring, the predicted effect-site propofol concentrations for the maintenance of anesthesia in patients undergoing gynecologic laparoscopy were similar in those administered adequate anesthesia at the skin incision during TCI.
URI
http://hdl.handle.net/YU.REPOSITORY/25768http://dx.doi.org/10.1111/j.1399-6576.2010.02327.x
ISSN
0001-5172
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의과대학 > 마취통증의학교실 > Articles
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