Predicted effect-site concentration of propofol and sufentanil for gynecological laparoscopic surgery
Source: Acta Anaesthesiologica Scandinavica, Volume 55, Number 1, January 2011 , pp. 110-117(8)
Abstract:Background: This study was to estimate the predicted effect-site concentration of propofol administered by a target-controlled infusion (TCI) for maintenance of anesthesia based on the bispectral (BIS) index as a measure of hypnosis in laparoscopic surgery. Method: One-hundred and sixty unpremedicated patients undergoing gynecologic laparoscopy were assigned randomly to receive one of the target effect-site concentrations of propofol 2.0, 2.5, 3.0, 3.5 and 4.0 μg/ml during TCI with propofol and sufentanil. The dose-response relationship of propofol for the maintenance of adequate anesthesia based on BIS, movement and hemodynamic response was investigated using a fixed effect-site concentration of sufentanil (0.2 ng/ml). The BIS values, hemodynamic variables, time course during emergence and intraoperative awareness were also assessed. Results: The predicted effect-site propofol concentrations for adequate anesthesia at the skin incision in 50% (EC50) and 95% (EC95) of patients undergoing gynecologic laparoscopy were 2.2 and 3.7 μg/ml, respectively. The predicted propofol EC50 and EC95 to maintain adequate anesthesia in these patients were 2.6 μg/ml (95% CI 2.3-2.7 μg/ml) and 3.6 μg/ml (95% CI 3.3-4.0 μg/ml), respectively. The BIS values, effect-site concentration of propofol, hemodynamic data and time course during emergence and post-operative adverse events were comparable in each group. There were no reports of intraoperative awareness in the post-anesthetic care unit. Conclusion: Based on the anesthetic depth assessed by the clinical signs and BIS monitoring, the predicted effect-site propofol concentrations for the maintenance of anesthesia in patients undergoing gynecologic laparoscopy were similar in those administered adequate anesthesia at the skin incision during TCI.
Document Type: Research article
Affiliations: 1: Department of Anesthesiology and Pain Medicine, School of Medicine, Konyang University Hospital, Daejeon, Korea 2: Department of Anesthesiology and Pain Medicine, School of Medicine, Inha University Hospital, Incheon, Korea
Publication date: 2011-01-01