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. 2018 Apr;62(4):263-268.
doi: 10.4103/ija.IJA_670_17.

Effect site concentration of propofol at induction and recovery of anaesthesia - A correlative dose-response study

Vasanth Sukumar  1 , Arathi Radhakrishnan  2 , Venkatesh H Keshavan  2
Affiliations

Effect site concentration of propofol at induction and recovery of anaesthesia - A correlative dose-response study

Vasanth Sukumar et al. Indian J Anaesth. 2018 Apr.

Abstract

Background and aims: Sound knowledge about effect site concentration (Ce) of propofol aids in smooth induction, maintenance and early recovery. We studied the correlation between Ce of propofol at loss of response to verbal command and recovery concentration using target-controlled infusion (TCI) in Indian patients who underwent spine surgeries.

Methods: Ninety patients undergoing spine surgeries were included. Total intravenous anaesthesia (TIVA) technique with TCI for propofol using modified Marsh model was used. Entropy and neuromuscular transmission were used. Ce at induction and recovery and the corresponding state entropy (SE) values were noted.

Results: The mean propofol Ce and SE at induction were 2.34 ± 0.24 μg/ml and 52 ± 8, respectively. The mean propofol Ce and SE at recovery were 1.02 ± 0.22 μg/ml and 86.80 ± 2.86, respectively. The Ce at recovery was approximately 50% of the induction value. The correlation coefficient 'r' between Ce at induction and recovery was 0.56. The mean infusion dose of propofol during the maintenance period was 81 ± 14.33 μg/kg/min. The average induction dose of propofol was 1.17 ± 0.2 mg/kg.

Conclusion: There is a positive correlation between Ce at induction and recovery. Ce for recovery may have to be set at a lower level during TCI-TIVA and appropriately infusion should be stopped for early recovery. The induction and maintenance doses of propofol are lower than the recommended doses. Data emphasise the need for pharmacokinetic model based on our population characteristics.

Keywords: Effect site; entropy; pharmacokinetic model; propofol.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Correlation between effect site concentration (Ce REC) and state entropy (SE REC) at recovery of consciousness
Figure 2
Figure 2
Correlation between effect site concentration at induction (Ce IND) and recovery of consciousness (Ce REC)
Figure 3
Figure 3
Trend of state entropy from end of propofol infusion. END – End of propofol infusion; EXT – Extubation; E5 – 5 min after extubation
Figure 4
Figure 4
State entropy values and propofol dosage at induction
See this image and copyright information in PMC

References

    1. Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P, et al. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology. 1997;86:836–47. - PubMed
    1. Jaap V, Elske S, Marije R. Intravenous anaesthetics. In: Miller R, editor. Miller's Anaesthesia. 8th ed. Philadelphia: Elsevier Inc; 2015. pp. 822–32.
    1. Kazama T, Ikeda K, Morita K, Ikeda T, Kikura M, Sato S, et al. Relation between initial blood distribution volume and propofol induction dose requirement. Anesthesiology. 2001;94:205–10. - PubMed
    1. Lysakowski C, Dumont L, Pellegrini M, Clergue F, Tassonyi E. Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia. Br J Anaesth. 2001;86:523–7. - PubMed
    1. Natarajan A, Strandvik GF, Pattanayak R, Chakithandy S, Passalacqua AM, Lewis CM, et al. Effect of ethnicity on the hypnotic and cardiovascular characteristics of propofol induction. Anaesthesia. 2011;66:15–9. - PubMed