keyword
https://read.qxmd.com/read/37541948/variability-of-predicted-propofol-concentrations-and-measured-sevoflurane-concentrations-during-general-anaesthesia-a-single-centre-retrospective-cohort-study
#21
JOURNAL ARTICLE
Thomas W Schnider, Charles F Minto
BACKGROUND: Variability is high in predicted propofol concentrations during clinical anaesthesia titrated by target-controlled infusion (TCI) to maintain a processed EEG parameter (bispectral index [BIS]) within a specified range. We have shown that the potential for improving the pharmacokinetic model is minimal. The drug titration paradox revealed that titration challenges the classical relationship between drug dose and effect in both individuals and the population. We hypothesised that dynamic factors during surgery beyond the static genetic, epigenetic, and other factors such as age, height, and weight affect the necessary dose...
October 2023: British Journal of Anaesthesia
https://read.qxmd.com/read/37331472/does-propofol-effect-site-brain-concentration-predicted-by-target-controlled-infusion-correlate-with-propofol-measured-in-the-brain-an-exploratory-study-in-neurosurgical-patients
#22
JOURNAL ARTICLE
Manish Beniwal, Radhakrishnan Muthuchellappan, Vikas Vazhayil, Priyamvadha Sharma, Nandakumar Dn, Daphine Anand Shravanthi, Hemant T Kumar, Mariamma Philip, Vivek Benegal
BACKGROUND: Total intravenous anaesthesia with propofol can be administered by target controlled infusion pumps which work on the principles of pharmacokinetic modelling. While designing this model, neurosurgical patients were excluded as the surgical site and the drug action site remain the same (brain). Whether the predicted set propofol concentration and the actual brain site concentration correlate, especially in neurosurgical patients with impaired blood brain barrier (BBB), is still unknown...
June 16, 2023: World Neurosurgery
https://read.qxmd.com/read/37327048/comparison-of-hemodynamic-changes-with-general-or-local-anesthesia-during-dental-treatment-in-pediatric-patients-a-prospective-clinical-study
#23
JOURNAL ARTICLE
Silvia Pérez-García, Johanna Acosta-Ibarra, Juan-Antonio Ruiz-Roca, Cristóbal Añez, Jordi Gargallo-Albiol
BACKGROUND AND AIM: Severe hemodynamic fluctuations during dental treatment can trigger highly undesirable physical reactions. A study was made to determine whether the administration of propofol and sevoflurane contributes to the stabilization of hemodynamic parameters during dental treatment in pediatric patients versus the use of local anesthesia alone. MATERIALS AND METHODS: Forty pediatric patients needing dental treatment were assigned to either general anesthesia with local anesthesia (study group [SG]) or local anesthesia alone (control group [CG])...
June 16, 2023: Special Care in Dentistry
https://read.qxmd.com/read/37314170/how-obesity-affects-the-disposition-of-intravenous-anesthetics
#24
JOURNAL ARTICLE
Shinju Obara, Keisuke Yoshida, Satoki Inoue
PURPOSE OF REVIEW: Understanding the changes in drug disposition of intravenous anesthetics in patients with obesity and administering appropriate doses are critical to avoid intraoperative awareness with recall because of underdosing and over-sedation and delayed emergence due to overdosing. Pharmacokinetic simulation or target-controlled infusion (TCI) using models that have been adapted to patients with obesity are necessary to select appropriate dosing regimens. This review aimed to describe the pharmacokinetic concepts underpinning the use of intravenous anesthetics, including propofol, remifentanil, and remimazolam, in patients with obesity...
June 9, 2023: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/37250255/monitoring-the-effects-of-automated-gas-control-of-sevoflurane-versus-target-guided-propofol-infusion-on-hemodynamics-of-liver-patients-during-liver-resection-a-randomized-controlled-trial
#25
JOURNAL ARTICLE
Yasmeen Abdelsalam Kamel, Noura Adel Ghareeb Sasa, Safaa Mohamed Helal, Hatem Amin Attallah, Khaled A Yassen
BACKGROUND AND AIMS: Cirrhotic patients are prone to hypotension during anesthesia. The primary aim of the study was to compare the effects of automated gas control (AGC) of sevoflurane and target-controlled infusion (TCI) of propofol on systemic and cardiac hemodynamics in hepatitis C cirrhotic patients undergoing surgery. The secondary aim was to compare the recovery, complications, and costs between the two groups. MATERIAL AND METHODS: This was a randomized controlled trial in adults with hepatitis C cirrhosis (Child A) who underwent open liver resection and received AGC (n = 25) or TCI (n = 25)...
2023: Journal of Anaesthesiology, Clinical Pharmacology
https://read.qxmd.com/read/37247817/accuracy-of-closed-loop-and-open-loop-propofol-delivery-systems-by-bispectral-index-monitoring-in-breast-surgery-patients-a-prospective-randomized-trial
#26
JOURNAL ARTICLE
Tian Xie, Yong Wang, Yuhua Liu, Junjie Li, Weijing Li, Hongmeng Xu
BACKGROUND: This randomized and controlled prospective study tested the hypothesis that closed-loop Target-Controlled Infusion (TCI) of propofol would be associated with better system performance when compared with open-loop controlled delivery of propofol. METHODS: Patients scheduled for elective breast surgery were randomly assigned to two groups: a closed-loop group, in which propofol infusion was performed by a closed-loop TCI system that used the Bispectral Index (BIS) as a feedback parameter to titrate the rate of propofol infusion, and an open-loop group, in which propofol infusion was performed manually and guided by the bispectral index...
May 27, 2023: Brazilian Journal of Anesthesiology
https://read.qxmd.com/read/37238272/application-of-bispectral-index-system-bis-monitor-to-ambulatory-pediatric-dental-patients-under-intravenous-deep-sedation
#27
JOURNAL ARTICLE
Shih-Chia Chen, Chun-Yu Chen, Shih-Jyun Shen, Yung-Fong Tsai, Yu-Chen Ko, Li-Chuan Chuang, Jr-Rung Lin, Hsin-I Tsai
Purpose Intravenous sedation has been well accepted to allow dental restoration in uncooperative children while avoiding aspiration and laryngospasm; however, intravenous anesthetics such as propofol may lead to undesired effects such as respiratory depression and delayed recovery. The use of the bispectral index system (BIS), a monitoring system reflective of the hypnotic state, is con-troversial in the reduction in the risk of respiratory adverse events (RAEs), recovery time, the in-travenous drug dosage, and post-procedural events...
May 18, 2023: Diagnostics
https://read.qxmd.com/read/37227973/effect-of-cyb2b6-c-516g-t-cyp2c9-c-1075a-c-and-ugt1a9-c-98t-c-polymorphisms-on-propofol-pharmacokinetics-in-patients-submitted-to-colonoscopy-a-cohort-study
#28
JOURNAL ARTICLE
Mara Aparecida Maricato Poma, Howard Lopes Ribeiro Junior, Eugênio Araújo Costa, Carlos Roberto Koscky Paier, Laís Lacerda Brasil, Luína Benevides Lima, Livia Maria Soares Nobre, Tayales Tavares Leite, Roberto César Pereira Lima-Júnior, Ana Rosa Pinto Quidute, Maria Elisabete Amaral de Moraes, Manoel Odorico de Moraes Filho
BACKGROUND: The aim of this study was to investigate the effect of CYB2B6 (c.516G>T, rs3745274), CYP2C9 (c.1075A>C, rs1057910) and UGT1A9 (c.98T>C, rs72551330) polymorphisms on the pharmacokinetics of single-drug propofol in adult patients undergoing intravenous sedation. METHODS: In this prospective clinical study, a total of 124 patients undergoing anaesthesia with propofol, as a single drug, were evaluated when undergoing colonoscopy procedure. Clinical variables were obtained from the patient's anamnesis prior to performing the anaesthetic procedure, in the moment of the patient's loss of consciousness, during the colonoscopy exam (recorded every 5 min) and in the awakening time...
May 22, 2023: Postgraduate Medical Journal
https://read.qxmd.com/read/37122939/recovery-time-in-target-controlled-infusion-versus-manual-infusion-of-propofol-in-total-intravenous-anaesthesia-for-endoscopic-retrograde-cholangio-pancreatography-procedure-using-laryngeal-mask-airway-gastro-a-randomised-comparative-study
#29
JOURNAL ARTICLE
Ayushi Sahu, Debendra Kumar Tripathy, Bhavna Gupta, Praveen Talawar, Rohit Gupta
BACKGROUND AND AIMS: This study aimed to compare manual infusion versus target-controlled infusion (TCI) in total intravenous anaesthesia (TIVA) utilising laryngeal mask airway (LMA)-gastro during endoscopic retrograde cholangio-pancreatography (ERCP) procedures. METHODS: This was a single-blind randomised trial. Patients were randomly allocated into two groups. TCI group included 27 patients, where TCI of propofol was implemented with the Schnider pharmacokinetic model driven by a computer-controlled syringe pump...
February 2023: Indian Journal of Anaesthesia
https://read.qxmd.com/read/36929537/pan-2022-0245-manuscript-title-relationship-between-decrement-time-and-recovery-time-in-pediatric-total-intravenous-anesthesia-with-propofol-and-remifentanil
#30
JOURNAL ARTICLE
Oliver Bagshaw
BACKGROUND: Propofol Target-controlled Infusion (TCI) is now used in many countries for the administration of Total Intravenous Anesthesia (TIVA) and uses population pharmacokinetic data incorporated into the target-controlled infusion pump to administer a dose which will achieve a target concentration selected by the practitioner. Modern TCI pumps can include an estimate of how long it will take for the plasma propofol concentration (Cp ) to fall to a value programmed into the pump, once the propofol infusion is stopped...
March 16, 2023: Paediatric Anaesthesia
https://read.qxmd.com/read/36889990/is-sedation-of-choice-in-thyroplasty-surgery-a-study-on-the-effects-of-sedatives-on-voice-quality
#31
JOURNAL ARTICLE
Ana Martín, José De Andrés, Natsuki Oishi, Manuel Granell, Rosa Hernández, María Otero, Enrique Zapater
OBJECTIVE: In order to establish the ideal anesthetic protocol in thyroplasty type I surgery, where the intraoperative voice test is used to guide the medialization of the paralyzed fold, we have studied the effects of a sedation with midazolam premedication and adjusted intravenous doses of propofol and remifentanil on voice quality in patients without vocal fold pathology undergoing otorhinolaryngology surgery other than thyroplasty. STUDY DESIGN: Prospective cross-sectional study included 40 adult patients...
March 6, 2023: Journal of Voice
https://read.qxmd.com/read/36819604/safety-and-efficacy-of-target-controlled-infusion-administration-of-propofol-and-remifentanil-for-moderate-sedation-in-non-hospital-dental-practice
#32
JOURNAL ARTICLE
Douglas Lobb, Masoud MiriMoghaddam, Don Macalister, David Chrisp, Graham Shaw, Hollis Lai
BACKGROUND: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. METHODS: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps...
February 2023: Journal of Dental Anesthesia and Pain Medicine
https://read.qxmd.com/read/36793626/efficacy-and-safety-of-propofol-target-controlled-infusion-combined-with-butorphanol-for-sedated-colonoscopy
#33
Feng Guo, De-Feng Sun, Yan Feng, Lin Yang, Jing-Lin Li, Zhong-Liang Sun
BACKGROUND: Propofol is a short-acting, rapid-recovering anesthetic widely used in sedated colonoscopy for the early detection, diagnosis and treatment of colon diseases. However, the use of propofol alone may require high doses to achieve the induction of anesthesia in sedated colonoscopy, which has been associated with anesthesia-related adverse events (AEs), including hypoxemia, sinus bradycardia, and hypotension. Therefore, propofol co-administrated with other anesthetics has been proposed to reduce the required dose of propofol, enhance the efficacy, and improve the satisfaction of patients receiving colonoscopy under sedation...
January 26, 2023: World Journal of Clinical Cases
https://read.qxmd.com/read/36767461/comparison-of-single-target-controlled-infusion-pump-delivered-mixed-propofol-and-remifentanil-with-two-target-controlled-infusion-pumps-delivered-propofol-and-remifentanil-in-patients-undergoing-breast-cancer-surgery-a-prospective-study
#34
RANDOMIZED CONTROLLED TRIAL
Hou-Chuan Lai, Meng-Fu Lai, Yi-Hsuan Huang, Jyh-Cherng Yu, Wei-Cheng Tseng, Zhi-Fu Wu
Total intravenous anesthesia (TIVA) with remifentanil and propofol (RP) is considered to be an ideal type of general anesthesia (GA) for pediatric and adult patients undergoing medical procedures. However, delivery of an RP mixture by target-controlled infusion (TCI) for GA in surgical procedures has not been described. We investigated the merit of this approach for breast cancer surgery. Eighty-four patients (n = 42 per group) were randomly allocated to propofol and remifentanil either delivered by separate TCI pumps (S group) or in an RP mixture by a single TCI pump (M group)...
January 23, 2023: International Journal of Environmental Research and Public Health
https://read.qxmd.com/read/36749481/effect-of-common-oprm1-comt-slc6a4-abcb1-and-cyp2b6-polymorphisms-on-perioperative-analgesic-and-propofol-demands-on-patients-subjected-to-thyroidectomy-surgery
#35
JOURNAL ARTICLE
Ioanna Soultati, Charikleia Ntenti, Georgia Tsaousi, Chryssa Pourzitaki, Dimitris Gkinas, Evanthia Thomaidou, Spiros Alexandrakis, Theodosios Papavramidis, Antonis Goulas
BACKGROUND: Perioperative anesthetic and/or analgesic demand present considerable variation, and part of that variation appears to be genetic in origin. Here we investigate the impact of common polymorphisms in OPRM1, COMT, SLC6A4, ABCB1, and CYP2B6 genes, on the intra-operative consumption of remifentanil and propofol, as well as the postoperative analgesic needs, in patients subjected to thyroidectomy surgery. METHODS: We conducted a prospective cohort study with 90 patients scheduled to undergo elective thyroidectomy, under total intravenous anesthesia achieved by target control infusion (TCI) of propofol and remifentanil...
February 7, 2023: Pharmacological Reports: PR
https://read.qxmd.com/read/36680980/unwanted-spontaneous-responsiveness-and-burst-suppression-in-patients-undergoing-entropy-guided-total-intravenous-anesthesia-with-target-controlled-infusion-an-observational-prospective-trial
#36
JOURNAL ARTICLE
Federico Linassi, Matthias Kreuzer, Stephan Kratzer, Sara Olivieri, Paolo Zanatta, Gerhard Schneider, Michele Carron
STUDY OBJECTIVE: To estimate the incidence of unwanted spontaneous responsiveness and burst suppression (BSupp) in patients undergoing state entropy (SE) and surgical pleth index (SPI)-guided total intravenous anesthesia (TIVA) with target-controlled infusion (TCI). DESIGN: Observational, prospective, single-center study. SETTINGS: Operating room. PATIENTS: 107 adult (<65 years) and elderly (≥65 years) women undergoing breast surgery...
January 19, 2023: Journal of Clinical Anesthesia
https://read.qxmd.com/read/36654900/to-ascertain-the-plasma-concentration-of-propofol-to-achieve-bispectral-index-guided-sedation-using-a-target-controlled-infusion-in-patients-undergoing-elective-surgeries-under-neuraxial-anaesthesia
#37
JOURNAL ARTICLE
Deepak Chhabra, Pradeep Bhatia, Priyanka Sethi, Narender Kaloria, Mritunjay Kumar, Manbir Kaur
BACKGROUND AND AIMS: Sedation improves patient satisfaction, comfort and acceptance of regional anaesthesia. Propofol using bispectral index (BIS)/target-controlled infusion (TCI) system can be an optimal method of sedation, as it combines objective measurement of sedation using BIS along with maintenance of a steady plasma concentration of propofol with the TCI device. The aim of this study was to ascertain the dose and safety of propofol using BIS/TCI system for sedation in patients undergoing surgeries under neuraxial anaesthesia...
December 2022: Indian Journal of Anaesthesia
https://read.qxmd.com/read/36624371/comparison-of-hemodynamics-during-induction-of-general-anesthesia-with-remimazolam-and-target-controlled-propofol-in-middle-aged-and-elderly-patients-a-single-center-randomized-controlled-trial
#38
RANDOMIZED CONTROLLED TRIAL
Ryo Sekiguchi, Michiko Kinoshita, Ryosuke Kawanishi, Nami Kakuta, Yoko Sakai, Katsuya Tanaka
BACKGROUND: Remimazolam confers a lower risk of hypotension than propofol. However, no studies have compared the efficacy of remimazolam and propofol administered using target-controlled infusion (TCI). This study aimed to investigate hemodynamic effects of remimazolam and target-controlled propofol in middle-aged and elderly patients during the induction of anesthesia. METHODS: Forty adults aged 45-80 years with the American Society of Anesthesiologists Physical Status 1-2 were randomly assigned to remimazolam or propofol group (n = 20 each)...
January 10, 2023: BMC Anesthesiology
https://read.qxmd.com/read/36609213/the-effect-of-preoperative-sleep-quality-on-the-target-plasma-concentration-of-propofol-and-postoperative-sleep-in-patients-undergoing-painless-gastroscopy
#39
JOURNAL ARTICLE
Yuxue Qiu, Haitao Hou, Junxia Zhang, Xiaomei Wang, Lu Wang, Yanan Wu, Liqin Deng
BACKGROUND: This study aims to investigate the effect of preoperative sleep quality on the target plasma concentration of propofol and postoperative sleep in patients undergoing painless gastroscopy. METHODS: Ninety-three outpatients aged 45 to 64 years with body mass index (BMI) of 18.5-30 kg/m2 and ASA grades of I or II, who underwent painless gastroscopy, were selected. All patients were evaluated by the Athens insomnia scale (AIS) before the painless gastroscopy...
January 7, 2023: BMC Anesthesiology
https://read.qxmd.com/read/36562193/alternatives-to-remifentanil-for-the-analgesic-component-of-total-intravenous-anaesthesia-a-narrative-review
#40
REVIEW
L M Hughes, M G Irwin, C C Nestor
Propfol-remifentanil-based total intravenous anaesthesia has dominated recent clinical practice due to its favourable pharmacokinetic profile. Interruption in remifentanil supply has presented an opportunity to diversify or even avoid the use of opioids and consider adjuncts to propofol-based total intravenous anaesthesia. Propofol, while a potent hypnotic, is not an effective analgesic. The administration of opioids, along with other adjuncts such as α-2 adrenoceptor agonists, magnesium, lidocaine, ketamine and nitrous oxide provide surgical anaesthesia and avoids large doses of propofol being required...
May 2023: Anaesthesia
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