Document Detail


Analysis of pharmacodynamic interaction of sevoflurane and propofol on Bispectral Index during general anaesthesia using a response surface model.
MedLine Citation:
PMID:  20385571     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Propofol and sevoflurane act on the GABA(A) receptor, modulating the function of this receptor in an additive manner. The pharmacodynamic interaction of both drugs considering their effect on EEG activity analysed by the bispectral index (BIS) was identified as additive, but this has not been studied in a clinical setting. The objective of this study was to analyse the pharmacodynamic interaction of propofol and sevoflurane on BIS using a surface response model in patients undergoing general anaesthesia with i.v. induction and inhalation maintenance. METHODS: We performed a prospective study in 24 patients undergoing general anaesthesia with propofol induction and sevoflurane maintenance. Anaesthetic depth was measured with a BIS VISTA Bilateral monitor. Propofol biophase concentration was determined using a three-compartment pharmacokinetic model, and sevoflurane end-tidal concentration was measured continuously. The response surface model described by Minto and colleagues was used to analyse the interaction. Statistical analysis was performed with Excel 2002 and SPSS v11.0. RESULTS: The mean value of U(50)(theta) was 0.956 (sd 0.029) in the overall estimated data, and remained within the predefined range for all ratios of the drugs, fulfilling the criterion of additivity. The median of the weighted residuals between the actual BIS value and the BIS value predicted by the model was -5.926%. CONCLUSIONS: Under the study conditions, it was confirmed that sevoflurane and propofol have an additive effect on BIS, with no evidence suggesting the existence of a synergistic effect for the concentrations of both drugs typically used in clinical practice.
Authors:
J C Diz; R Del R?o; A Lamas; M Mendoza; M Dur?n; L M Ferreira
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-12
Journal Detail:
Title:  British journal of anaesthesia     Volume:  104     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-12     Completed Date:  2010-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  733-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Critical Care, Hospital Xeral-C?es, Vigo, Spain. jcdiz@uvigo.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anesthesia, General / methods
Anesthetics, Combined / pharmacology*
Anesthetics, Inhalation / pharmacology
Anesthetics, Intravenous / pharmacology
Drug Interactions
Electroencephalography / drug effects*
Female
Humans
Male
Methyl Ethers / pharmacology*
Middle Aged
Models, Biological
Monitoring, Intraoperative / methods
Propofol / pharmacology*
Prospective Studies
Chemical
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 2078-54-8/Propofol; 28523-86-6/sevoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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