Keyl, Cornelius and Trenk, Dietmar and Laule, Sven and Schuppe, Christine and Staier, Klaus and Wiesenack, Christoph and Albiez, Georg (2009) Predicted and Measured Plasma Propofol Concentration and Bispectral Index During Deep Sedation in Patients With Impaired Left Ventricular Function. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 23 (2). pp. 182-187. ISSN 1053-0770, 1532-8422
Full text not available from this repository. (Request a copy)Abstract
Objective: To evaluate the ability of the Schnider pharmacokinetic model to predict plasma propofol concentration during target-controlled propofol infusion in patients with impaired left ventricular function and to investigate the predictive value of the bispectral index (BIS) to indicate deep sedation in this patient group. Design: Prospective, observational study. Participants: Thirty-four patients (mean left ventricular ejection fraction 31% +/- 9%) undergoing the implantation of a cardioverter-defibrillator during deep sedation. Interventions: None. Measurements and Main Results: Predicted and measured propofol plasma concentrations and BIS were assessed during steady-state conditions with the propofol infusion rate constant for at least 20 minutes. The plasma propofol concentration was significantly underestimated by the pharmacokinetic model used (mean percentage prediction error 37% +/- 49%). The 50% probability of deep sedation was calculated at a predicted propofol concentration of 2.09 (95% confidence interval [CI], 2.04-2.14) mu g/mL and at a measured propofol concentration of 2.70 (95% CI, 2.62-2.78) mu g/mL. BIS values showed a marked variability among individuals during deep sedation (5th-95th percentiles: 25-81). Conclusions: The pharmacokinetic model used markedly underestimated propofol plasma levels in the patient group studied. The large variability among patients suggests that BIS monitoring is not suitable for indicating an exact end-point corresponding to deep sedation. (C) 2009 Elsevier Inc. All rights reserved
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TARGET-CONTROLLED INFUSION; EFFECT-SITE CONCENTRATION; CARDIOVERTER-DEFIBRILLATORS; PHARMACOKINETIC MODEL; CONSCIOUS SEDATION; ANESTHESIA; PERFORMANCE; VOLUNTEERS; MIDAZOLAM; SURGERY; plasma propofol concentration; target-controlled infusion; impaired left ventricular function; bispectral index |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 Sep 2020 13:21 |
| Last Modified: | 18 Sep 2020 13:21 |
| URI: | https://pred.uni-regensburg.de/id/eprint/29176 |
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