Document Detail


Interaction Between Nitrous Oxide, Sevoflurane, and Opioids: A Response Surface Approach.
MedLine Citation:
PMID:  23360899     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The interaction of sevoflurane and opioids can be described by response surface modeling using the hierarchical model. We expanded this for combined administration of sevoflurane, opioids, and 66 vol.% nitrous oxide (N2O), using historical data on the motor and hemodynamic responsiveness to incision, the minimal alveolar concentration, and minimal alveolar concentration to block autonomic reflexes to nociceptive stimuli, respectively. METHODS:: Four potential actions of 66 vol.% N2O were postulated: (1) N2O is equivalent to A ng/ml of fentanyl (additive); (2) N2O reduces C50 of fentanyl by factor B; (3) N2O is equivalent to X vol.% of sevoflurane (additive); (4) N2O reduces C50 of sevoflurane by factor Y. These four actions, and all combinations, were fitted on the data using NONMEM (version VI, Icon Development Solutions, Ellicott City, MD), assuming identical interaction parameters (A, B, X, Y) for movement and sympathetic responses. RESULTS:: Sixty-six volume percentage nitrous oxide evokes an additive effect corresponding to 0.27 ng/ml fentanyl (A) with an additive effect corresponding to 0.54 vol.% sevoflurane (X). Parameters B and Y did not improve the fit. CONCLUSION:: The effect of nitrous oxide can be incorporated into the hierarchical interaction model with a simple extension. The model can be used to predict the probability of movement and sympathetic responses during sevoflurane anesthesia taking into account interactions with opioids and 66 vol.% N2O.
Authors:
Hugo E M Vereecke; Johannes H Proost; Bjorn Heyse; Douglas J Eleveld; Takasumi Katoh; Martin Luginbühl; Michel M R F Struys
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Consultant Anesthesiologist and Assistant Professor, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. † Associate Professor, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. ‡ Consultant Anesthesiologist, Department of Anesthesia, University Hospital Ghent, Ghent, Belgium. § Research Engineer, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. ‖ Associate Professor, Department of Anesthesia and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Japan. # Chair of the Department of Anesthesiology, Bern Hospital Network/University of Bern, Switzerland. ** Professor and Chair, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands and Professor, Department of Anesthesia, Ghent University, Ghent, Belgium.
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