Document Detail


The influence of age on the dynamic relationship between end-tidal sevoflurane concentrations and bispectral index.
MedLine Citation:
PMID:  18931213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Age is an important determinant of the pharmacokinetic profile of inhaled anesthetics. The influence of age on the dynamic profile of sevoflurane's effect has not been well described. We performed this study to characterize the influence of age and other covariates on the dynamic relationship between sevoflurane end-tidal concentration (C(ET)) and its effect measured by bispectral index (BIS). METHODS: Fifty patients, aged 3-71 yr, scheduled for minor surgery were prospectively studied. The BIS and sevoflurane C(ET) were continuously measured during the study period. During maintenance of anesthesia and after stable BIS values of 60-65 were obtained, the inspired concentration of sevoflurane was increased to 5 vol % for 5 min or until BIS <40 and then decreased. The dynamic relationship between sevoflurane C(ET) and its effect as measured by BIS during this transition period were modeled with an inhibitory E(max) model using a population pharmacokinetic-pharmacodynamic approach with NONMEM V. A predictive check method was used to validate the final model. RESULTS: The sensitivity to sevoflurane's effect as measured by BIS expressed in the C(50) [steady-state C(ET) eliciting half of maximum response (I(max))] increased with age. The speed of change of sevoflurane's effect, expressed as the effect-site equilibration half-life (t(1/2) k(e0)), increased at older ages. The predictive check analysis confirmed the adequacy of the model. CONCLUSIONS: Age significantly affects the dynamic relationship between sevoflurane C(ET) and its effect measured with BIS.
Authors:
Luis I Cortínez; Iñaki F Trocóniz; Ricardo Fuentes; Pedro Gambús; Yung-Wei Hsu; Fernando Altermatt; Hernán R Muñoz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  107     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1566-72     Citation Subset:  AIM; IM    
Affiliation:
Departmento de Anestesiología, Hospital Clínico U.C., Marcoleta 367, Santiago, Chile. licorti@med.puc.cl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aging / drug effects,  physiology*
Anesthetics, Inhalation / pharmacology*
Child
Child, Preschool
Drug Hypersensitivity
Electroencephalography / drug effects
Humans
Methyl Ethers / pharmacology*
Middle Aged
Tidal Volume* / drug effects
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane

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


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