30 September 2009
Pharmacokinetics and pharmacodynamics of propofol during propofol-alfentanil and propofol-remifentanil total intravenous anaesthesia monitored by spectral frequency index
Agnieszka BienertABCDEFG, Zbigniew ZabaABCDEFG, Edmund GrzeskowiakDE, Krzysztof KuszaAE, Tomasz GrabowskiCEMed Sci Monit 2009; 15(10): PI47-53 :: ID: 878195
Abstract
Background
The aim of this study was to examine the pharmacokinetic and pharmacodynamic profile of propofol during propofol remifentanil and propofol - alfentanil anaesthesia, when monitored by SFx.
Material and Method
Thirty-three ASA physical status I-II patients scheduled for laparoscopic cholecystectomy were prospectively randomized to 1 of 2 groups according to type of opioid used (remifentanil or alfentanil). The propofol infusion rate was adjusted to the spectral frequency index (SFx) value. Venous blood samples were collected from patients during and after anaesthesia. Propofol was assayed by means of the HPLC method with fluorescence detection. The remifentanil and alfentanil groups were compared in relation to pharmacokinetic and pharmacodynamic parameters of propofol and a t-test was used for statistical analysis.
Results
The propofol mean total body clearance rate and the volume of distribution were significantly higher in the propofol - remifentanil group. There were not any statistically significant differences between the groups in mean EC(50), E(0), E(max) and k(e0) values. However, large interindividual variability was observed in EC(50) and k(e0) mean values. The value of ET(50) was significantly higher in the remifentanil group.
Conclusions
Alfentanil decreases the elimination clearance and the volume of distribution at steady state of propofol to a greater extent than with remifentanil. Our results suggest that if propofol is administrated by manual control, the same infusion rate should be used in the presence of alfentanil and remifentanil. For target controlled infusion, the same target propofol concentration should be used when both remifentanil and alfentanil are coadministrated.
Keywords: Propofol - therapeutic use, Piperidines - pharmacology, Monitoring, Physiologic - methods, Demography, Anesthetics, Intravenous - pharmacology, Anesthesia, Intravenous - methods, Alfentanil - pharmacology
795 22
Editorial
01 December 2023 : Editorial
Editorial: Outbreaks of Post-Pandemic Childhood Pneumonia and the Re-Emergence of Endemic Respiratory InfectionsDOI: 10.12659/MSM.943312
Med Sci Monit 2023; 29:e943312
In Press
04 Dec 2023 : Animal Research
Effects of Intrathecal Ketamine on Cerebrospinal Fluid Levels of Brain-Derived Neurotrophic Factor and Mech...Med Sci Monit In Press; DOI:
01 Dec 2023 : Clinical Research
Risk Factors and Clinical Outcomes of COVID-19 Infection in Multiple Sclerosis Patients: A Retrospective St...Med Sci Monit In Press; DOI:
30 Nov 2023 : Review article
Decoding the Neurological Sequelae of General Anesthesia: A ReviewMed Sci Monit In Press; DOI:
30 Nov 2023 : Clinical Research
Enhanced Pain Relief and Muscle Growth in Individuals with Low Back Instability: The Impact of Blood Flow R...Med Sci Monit In Press; DOI:
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292