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ANESTHETIC PHARMACOLOGY

The Recovery of Senegalese African Blacks from Intravenous Anesthesia with Propofol and Remifentanil Is Slower Than That of Caucasians

Oreste Ortolani, MD^*, Anna Conti, BSci, Bineta Sall/Ka, MD, Jean Pierre Salleras, MD, Elisabeth Diouf, MD, Ohmar Kane, MD, Stephen J. Roberts, ESci, and Gian Paolo Novelli, MD^*

*Universita’ di Firenze, Dipartimento di Area Critica Medico Chirurgica, Firenze, Italy; Universita’ di Napoli "Federico II," Dipartimento di Patologia e Biologia Molecolare e Cellulare, Napoli, Italy; Universite’ de Dakar, Service de Anestesie et Reanimation C.H.U. Le Dantec, Dakar, Senegal; and Oxford University, Department of Engineering Science, Oxford, United Kingdom

Address correspondence and reprint requests to Professor Oreste Ortolani, Via Carducci, 42 80121 Naples, Italy. Address e-mail to o.ortolani{at}dfc.unifi.it

Differences in sensitivity to anesthetic drugs have already been described among races. This study was designed to comparatively investigate the anesthetic requirements of two different ethnic groups: Caucasians and African blacks. Forty-five Caucasians from Italy and 45 African blacks from Senegal, who underwent general IV anesthesia with propofol and remifentanil, were comparatively evaluated for anesthetic depth and time lapsed before recovery. We used an electroencephalographic-derived index of depth of anesthesia, the bispectral index (BIS), and evaluation of clinical variables to assess the depth of anesthesia and the recovery trend. Mean BIS values from Caucasians after propofol dis- continuation returned to baseline (92–100) in approximately 8 min, whereas in African blacks BIS values remained <80 for some 30 min. Time to eye opening was 10.6 ± 4.8 min in Caucasians versus 16.9 ± 8.8 min in African blacks (P < 0.001). Time to respond to loud verbal commands was 14.8 ± 9.1 min in African blacks versus 9.1 ± 4.2 min in Caucasians (P < 0.01). During anesthetic induction, the mean arterial pressure decreased by 20% in Caucasians and by only 10% in African blacks. We conclude that the recovery from general anesthesia with propofol was slower in African blacks compared with Caucasian patients.

IMPLICATIONS: This study demonstrates statistically significant differences between Caucasians and African blacks in the arousal time from IV anesthesia with propofol and remifentanil. The authors conclude that the recovery from general anesthesia was slower in African blacks compared with Caucasian patients.

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