JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Wietasch, J. K. G. Articles by Hoeft, A. Search for Related Content PubMed PubMed Citation Articles by Wietasch, J. K. G. Articles by Hoeft, A.

---

ANESTHETIC PHARMACOLOGY

The Performance of a Target-Controlled Infusion of Propofol in Combination with Remifentanil: A Clinical Investigation with Two Propofol Formulations

J. K. Götz Wietasch, MD^*, Martin Scholz, MD, Jörg Zinserling, MS, Nicholas Kiefer, MD, Christian Frenkel, MD, PhD, Pascal Knüfermann, MD, Ute Brauer, MD, and Andreas Hoeft, MD, PhD

*Department of Anesthesiology, University Medical Center Groningen, The Netherlands; Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Germany; Medical Department, Division Hospital Care, B. Braun Melsungen AG, Melsungen, Germany; Department of Anesthesiology, Lüneburg, Germany

Address correspondence and reprint requests to J. K. Götz Wietasch, MD, Department of Anesthesiology, Groningen University Hospital, PO Box 30001, 9700 RB, Groningen, The Netherlands. Address e-mail to j.k.g.wietasch{at}anest.umcg.nl.

Target-controlled infusion (TCI) incorporates the pharmacokinetic variables of an IV drug to facilitate safe and reliable administration. In this clinical study we investigated the performance of propofol TCI in combination with remifentanil. Fifty-four adult patients scheduled for general surgery lasting longer than 1 h received a combined TCI of propofol (Marsh parameter set; propofol randomly either dissolved with long- or middle-/long-chain triglycerides) and remifentanil. Arterial propofol plasma concentrations and hemodynamic and derived electroencephalogram variables were determined at various stages before, during, and after surgery. Measured propofol plasma concentrations exceeded the predicted values by 59%, and 48% when recalculated with the Schnider parameter set. Pharmacokinetic population analysis showed a small central volume of distribution (3.55 L) and reduced clearance (1.31 L/min) for propofol. ASA status and sex were the only variables that had a significant influence on propofol pharmacokinetics. In a second step, a new pharmacokinetic variable set for propofol was determined in the first 27 patients. Post hoc performance analysis of the remaining 27 patients showed improved accuracy using the new variable set. Our results show that when remifentanil and propofol are combined, the Marsh and Schnider parameter sets systematically underestimate propofol plasma concentrations. Presented, in part, at the Annual Meeting of the European Society of Anesthesiologists, Amsterdam, The Netherlands, June 1, 1999, and the Annual Meeting of the American Society of Anesthesiologists, Dallas, Texas, October 12, 1999.

This article has been cited by other articles:

				A. Rigouzzo, L. Girault, N. Louvet, F. Servin, T. De-Smet, V. Piat, R. Seeman, I. Murat, and I. Constant The Relationship Between Bispectral Index and Propofol During Target-Controlled Infusion Anesthesia: A Comparative Study Between Children and Young Adults Anesth. Analg., April 1, 2008; 106(4): 1109 - 1116. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999