Journal article
A pharmacodynamic analysis of factors affecting recovery from anesthesia with propofol-remifentanil target controlled infusion
Acta pharmacologica Sinica, Vol.33(8), pp.1080-1084
08/01/2012
DOI: 10.1038/aps.2012.85
PMCID: PMC4011327
PMID: 22842732
Abstract
Aim: To examine individual patient's demographic parameters and clinical variables related to return of consciousness (ROC) and the pharmacodynamic relationship between propofol effect-site concentration (C-e) and ROC from propofol-remifentanil anesthesia.
Methods: Ninety-four patients received propofol-remifentanil anesthesia using the effect-site target-controlled infusion (TCI) system. All clinical events were noted, and variables possibly related to propofol C-e at ROC were examined using linear correlation analyses. Pharmacodynamic modeling incorporating covariates was performed using NONMEM (Nonlinear Mixed Effects Modeling) VII software.
Results: The C-e values of propofol at loss of consciousness (LOC) and ROC were 4.4 +/- 1.1 mu g/mL and 1.1 +/- 0.3 mu g/mL, respectively. Age was negatively correlated with propofol C-e at ROC (r=-0.48, P<0.01). Including age as a covariate in C-e50 (the effect-site concentration associated with 50% probability of return of consciousness) and. (the steepness of the concentration-versus-response relationship) significantly improved the performance of the basic model based on the likelihood ratio test, with a significant decrease in the minimum value of the objective function. The C-e50 in 25-, 50-, and 75-year-old patients was predicted to be 1.38, 1.06, and 0.74 mu g/mL, respectively. The lambda in 25-, 50-, and 75-year-old patients was predicted to be 12.23, 8.70, and 5.18, respectively.
Conclusion: Age significantly affects the relationship between propofol C-e and ROC, and pharmacodynamic modeling including age could lead to better predictions of ROC during emergence from propofol-remifentanil anesthesia.
Details
- Title: Subtitle
- A pharmacodynamic analysis of factors affecting recovery from anesthesia with propofol-remifentanil target controlled infusion
- Creators
- Bon-nyeo Koo - Yonsei UniversityJeong-rim Lee - Yonsei UniversityGyu-jeong Noh - University of UlsanJae-hoon Lee - Yonsei UniversityYoung-ran Kang - Yonsei UniversityDong-woo Han - Yonsei University
- Resource Type
- Journal article
- Publication Details
- Acta pharmacologica Sinica, Vol.33(8), pp.1080-1084
- DOI
- 10.1038/aps.2012.85
- PMID
- 22842732
- PMCID
- PMC4011327
- NLM abbreviation
- Acta Pharmacol Sin
- ISSN
- 1671-4083
- eISSN
- 1745-7254
- Publisher
- ACTA PHARMACOLOGICA SINICA
- Number of pages
- 5
- Grant note
- Yonsei University
- Language
- English
- Date published
- 08/01/2012
- Academic Unit
- Anesthesia
- Record Identifier
- 9984806608202771
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