Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Propofol”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed2000

[A new sedation technique with propofol during spinal anesthesia].

We compared our new sedation technique with propofol during spinal anesthesia (Group B, n = 50) with a previously described method by Mackenzie et al. (Group A, n = 20). In Group A, propofol was started at a rate of 6 mg.kg-1.h-1 for 10 minutes, followed by continuous infusion at a rate of 4 mg.kg-1.h-1 till the end of surgery. In Group B, propofol 0.4 mg.kg-1 was administered by a bolus injection at the beginning. One-hundred and fifty minutes after the first injection, propofol 0.2 mg.kg-1 was added. The third dose of 0.1 mg.kg-1 of propofol was given 150 seconds after the second dose, followed by continuous infusion at a rate of 4 mg.kg-1.h-1 till the end of surgery. When adequate sedation was not obtained in Group B, propofol 0.1 mg.kg-1 was added by bolus fashion occasionally. In Group A, it took 9 min. 29 sec. to complete adequate sedation assessed by Mackenzie and Grant's sedation score. On the other hand, in Group B, it was 7 min. 27 sec. (P < 0.05 compared with Group A). There was neither excitation nor movement during sedation in Group B, while 5 patients experienced such events in Group A. The blood concentrations of propofol in Group B was 0.946 +/- 0.076 microgram.ml-1 and 0.693 +/- 0.136 microgram.ml-1 at 5 minutes and 10 minutes after the beginning of propofol, respectively. These values were significantly lower than those reported by Kugimiya. Our newly developed method for sedation with propofol during spinal anesthesia would be safer and more effective than that previously described by Mackenzie et al.

Adolescent↗
PubMed2000

Propofol-sodium thiopental admixture reduces pain on injection.

BACKGROUND: Propofol injection associated with a high incidence of pain is well known. Propofol and sodium thiopental mixture has recently been reported to be used for cost saving and able to reduce pain on injection. METHODS: This prospective, randomized, double blind trial was designed to compare the efficacy of different percentages of propofol and sodium thiopental mixture in minimizing propofol injection pain. 146 ASA class 1 patients were assigned to seven groups (pure propofol, pure sodium thiopental, and propofol premixed with 10%, 20%, 30%, 40%, and 50% of sodium thiopental). The intensity of pain was graded and recorded as severe, moderate, mild and no pain according to the response of the patients to the injection. RESULTS: The intensity of injection pain was significantly greater for pure propofol than the others while it was not significantly different among the other groups in comparison. CONCLUSIONS: Sodium thiopental, when added to propofol, can significantly reduce propofol injection pain. This attenuation effect was noted even with as low as 10 volume % of sodium thiopental.

Adult↗
PubMedDate not supplied

[The effect of encephalogram bispectral index monitoring during total intravenous anesthesia with propofol in outpatient surgery].

OBJECTIVE: To assess the effect of monitoring the encephalogram bispectral index (BIS) during outpatient surgery. Outcome measures were amount of propofol administered, awakening and discharge. MATERIAL AND METHODS: Forty consecutive outpatient surgery patients were studied. The patients gave informed consent and received general intravenous anesthesia with propofol administered through a laryngeal mask using a computerized system (Diprifusor(R)). Two groups were formed: in group A, BIS was monitored, although the information was hidden from the anesthesiologists, who used the usual signs (loss of blinking reflex, pupil size and hemodynamic response) to guide anesthesia; in group B the anesthesiologists used BIS monitoring to guide propofol administration. Measurements were blood pressure, heart rate and BIS at six times during the procedure (T1-T6). Other data recorded were age, weight, height, propofol consumption in relation to weight and duration of procedure, consumption of rocuronium and alfentanil, duration of propofol infusion, time from withdrawal of propofol until eye opening, duration of stay in the post-anesthesia intensive care unit and time until total recovery. A questionnaire assessed the presence of intraoperative awareness and degree of satisfaction. The data were analyzed by Student's t and a chi square tests, with statistical significance at p < 0.05. RESULTS: Demographic variables (age, weight and height) were similar, as were duration of propofol infusion, total dose of alfentanil and rocuronium, evolution of blood pressure and heart rate. Statistically significant differences in BIS were observed at two times, T4 and T5; total propofol administered was 32.6% lower in group B; and time until eye opening was significantly shorter in group B. No significant differences were observed for time until full recovery. No instances of intraoperative awareness were reported and satisfaction was high in both groups. CONCLUSION: BIS monitoring allows for propofol titration that leads to a mean reduction of 32.6% in consumption, shortening the time until eye opening without causing intraoperative awareness or reducing patient satisfaction.

Adult↗
PubMed2001

Hemodynamic responses of thiopental and propofol in different-aged patients during endotracheal intubation.

BACKGROUND: Thiopental and propofol are 2 popularly used anesthetic induction agents that have different pharmacological and pharmacokinetic actions. It is not clear how the hemodynamic responses differ in different-aged patients using these 2 drugs for anesthetic induction. The aim of this study was to investigate the hemodynamic responses to propofol and thiopental of different-aged patients during endotracheal intubation. METHODS: Sixty patients, 20 to 83 years old, were included in this study. Patients were randomly divided into 6 groups according to age and different inductive anesthetics. Non-invasive blood pressure (NIBP) monitoring was performed every minute before anesthesia, during anesthetic induction with 5 mg.kg-1 thiopental or 2 mg.kg-1 propofol intravenously, and after intubation. RESULTS: Propofol induction produced a smaller mean arterial pressure increase immediately after intubation than did thiopental induction in adult and elderly groups (101.0 +/- 18.5 and 104.0 +/- 21.1 mmHg in the propofol groups vs. 138.3 +/- 17.1 and 138.9 +/- 16.1 mmHg in the thiopental groups at 1 minute after intubation, p < 0.001 and p = 0.001, respectively). Differences in heart rate between propofol and thiopental groups were found in young and adult groups (85.1 +/- 9.2 and 81.7 +/- 10.9 in the propofol groups vs. 94.5 +/- 9.9 and 95.0 +/- 14.0 beats per minute in the thiopental groups at 1 minute after intubation, p = 0.041 and p = 0.029, respectively). CONCLUSION: Propofol induction produced more stable hemodynamics after intubation in adult and elderly patients than did thiopental induction. Therefore, it is safer to use propofol for induction and intubation in adult and elderly patients.

Adult↗
PubMed2001

Effects of propofol on mitochondrial function and intracellular calcium shift in bovine aortic endothelial model.

BACKGROUND: Hypotension was commonly encountered in clinical practice during induction of anesthesia with propofol. The purpose of this study is to investigate the effect of propofol on mitochondrial membrane potential and morphology so as to infer its relation with intracellular calcium mobilization in bovine aortic endothelium. METHODS: In this study, we used the cultured bovine aortic endothelial cells (Gm 7372a) to elucidate the impact of propofol upon the membrane potential and morphology of mitochondria in correlation with its effect on intracellular calcium shift. The intracellular calcium mobilization within the cells preincubated with or without propofol was evaluated using a fluorescent spectrophotometer (confocal microscope) after being treated with Fluo-3. The mobilization of intracellular calcium was demonstrated by the appearance of "hot spots" released from intracellular stores after the addition of an ionophore, ionomycin, to the incubation system. The membrane potential of mitochondria was measured by DiOC6 and the morphology of the mitochondria was evaluated by the treatment of TM Ros and compared with that by the treatment of the uncoupler, FCCP, as control. RESULTS: The release of calcium "hot spots" from the intracellular stores (e.g. mitochondria) after the addition of ionomycin was visualized to decrease dramatically within the endothelial cells after preincubation with propofol. The membrane potential of mitochondria was significantly inhibited by pretreatment of propofol at 0.01 mM, 37 degrees C for 30 min. Morphologically, the integrity of mitochondria was distorted and fragmented in the presence of propofol as compared with that of control. CONCLUSIONS: Our data showed that propofol in clinical concentration, 0.01 mM, could inhibit intracellular calcium shift from the intracellular stores and decrease the membrane potential and distort the morphology of mitochondria in bovine aortic endothelial cells. These inhibitions of the function and disfiguration of the morphology of mitochondria signify that the clinical hypotension induced by propofol might be of a potential mechanism.

Anesthetics, Intravenous↗
PubMed2002

Propofol infusion is associated with a higher rapid shallow breathing index in patients preparing to wean from mechanical ventilation.

OBJECTIVE: To determine whether propofol affects spontaneous breathing patterns in critically ill patients recovering from respiratory failure during initial attempts at liberation from mechanical ventilation. DESIGN: Observational cohort study. PATIENTS: Ten critically ill patients in the medical intensive care unit of a 300-bed community teaching hospital. MEASUREMENTS: Demographic and physiologic variables, including respiratory frequency and minute volume, were recorded while patients breathed on continuous positive airway pressure (of 5 cm H(2)O) during and 20-30 min after cessation of propofol infusion. The ratio of respiratory frequency to tidal volume (rapid shallow breathing index or RSBI) was computed for both sets of measurements and values measured during and after propofol infusion were compared. RESULTS: The mean (+/- SEM) age was 54.0 +/- 5.2 years and the mean (+/- SEM) APACHE II (Acute Physiology and Chronic Health Evaluation) score was 18.4 +/- 2.0. During propofol infusion, patients breathed with a significantly lower tidal volume (0.245 vs 0.342 L, p = 0.006), higher RSBI (155.6 vs 114.8 breaths/min/L, p = 0.004), and tended to breathe more rapidly (34.3 vs 31.7 breaths/min, p = 0.18) than at 20-30 min after stopping propofol infusion. Three of 10 patients had RSBIs that were unfavorable (> 105 breaths/min/L) for weaning while on propofol but that became favorable (< 105 breaths/min/L) 20-30 min following cessation of propofol. The weight-adjusted dose of propofol was not correlated with the changes in any of the variables. CONCLUSIONS: Propofol causes changes in breathing pattern that could lead a caregiver to erroneously conclude that a patient is not ready to begin spontaneous breathing trials. Since this effect has also been noted following benzodiazepine infusion, the clinician should consider the patient's "sedation history" when using RSBI to guide weaning decisions.

APACHE↗
PubMed2002

Effect of 1% and 2% propofol on blood lipids during longterm sedation.

OBJECTIVES: To compare the effects of 1% and 2% propofol on the maximum and average lipid levels, the relative frequency of hyperlipidaemia, the propofol dose required to achieve an equivalent degree of sedation, the pharmacodynamic effects at the required infusion rates, and the effect on respiratory function. DESIGN: Open, randomised, parallel group, multicentre comparison study. SETTING: Intensive care units (ICUs) at the Faculty of Medicine, University of Stellenbosch and at Vergelegen Medicity, Somerset West. SUBJECTS: Patients who were artificially ventilated for at least 72 hours in the ICUs and who required sedation or analgesia. OUTCOME MEASURES: Continuous intravenous infusion of 1% or 2% propofol to provide an administration rate in the range of 1-4 mg/kg/h. The initial infusion rate was about 2 mg/kg/h, adjusted to achieve the appropriate level of sedation. RESULTS AND CONCLUSIONS: Seventy-five patients were enrolled in the study, of which 72 were evaluable for safety analysis and 58 were evaluable for efficacy analysis. The total daily dose of propofol (ml/day) in the 2% propofol group was about 60% of that in the 1% propofol group, indicating that the lipid load in the 2% propofol group had only slightly more than half the lipid load in the 1% propofol group. Thirteen of 27 patients (48%) in the 2% propofol group had abnormally.

Adult↗
PubMed2003

[Feasibility study of controlled hypotension induced with combination of propofol and desflurane in craniotomy].

OBJECTIVE: To evaluate the feasibility of controlled hypotension induced with combination of propofol and desflurane in craniotomy. METHODS: Thirty-five ASA I approximately II patients undergoing elective craniotomy were randomly selected. Anesthetic induction was achieved with midazolam, thiopental, fentanyl, and vecuronium. Anesthesia was maintained with infusion of propofol and inhalation of desflurane. The propofol infusion rate and desflurane inhalation concentration were raised during isolation and resection of the tumors so that the mean arterial pressure (MAP) was reduced by 30% - 40% and > 50 mm Hg and maintained at this level for 30 - 45 min. After the resection of tumor, the propofol infusion rate and desflurane inhalation concentration were reduced so as to let the MAP increase to normal level. MAP, heart rate (HR), cerebrospinal fluid pressure (CSFP), propofol infusion rate, and inhalation concentration of desflurane were recorded before controlled hypotension, at the 1st, 3rd, 5th, 10th, 20th and 30th minute of the procedure of controlled hypotension, and just before the increase of blood pressure and 1, 3, 5, 10, 20, 30, 40 and 50 minutes after controlled hypotension. The awakening status was observed. Arterial and jugular bulb venous blood samples were taken before, during and after hypotension and the arterial to jugular bulb venous oxygen content difference [D(a-jv)O(2)] and cerebral oxygen extraction rate (ERO(2)) were measured. RESULTS: The time needed to reach controlled hypotension was 6 - 35 minutes and that needed to reach the normal blood pressure was 12 - 41 minutes. The propofol infusion rate and inhalation concentration of desflurane needed to maintain controlled hypotension were 51 micro g x kg(-1) x min(-1) +/- 27 micro g x kg(-1) x min(-1) and 6.4% +/- 4.1% respectively. HR increased significantly in the initial stage and returned to baseline value after 3 - 14 min during the controlled hypotension. CSFP decreased significantly after incision of dura mater of brain and during controlled hypotension (P < 0.05). The recovery time after weaning from propofol infusion and desflurane inhalation until eye opening in response to order and autonomous breathing was 25 min +/- 19 minutes. The time needed to regain autonomous breathing with the tidal volume > 300 ml/time was 17 min +/- 10 minutes. Compared with those before hypotension, the SjvO(2) was increased significantly, and D(a-jv)O(2) and ERO(2) were decreased significantly during hypotension (P < 0.05). CaO(2) and CjvO(2) remained unchanged throughout the process of hypotension (P > 0.05). CONCLUSION: With low propofol infusion rate and low desflurane inhalation concentration, rapid hypotension, rapid recovery of breathing after operation, a short recovery time from anesthesia, and decreased CSFP and brain oxygen metabolism, controlled hypotension with propofol infusion and desflurane inhalation is suitable to intracranial surgery.

Adult↗
PubMed2003

An evaluation of analgesic efficacy and clinical acceptability of intravenous tramadol as an adjunct to propofol sedation for third molar surgery.

This article details a double-blind, randomized, placebo-controlled pilot study evaluating the analgesic efficacy and clinical acceptability of intravenous tramadol in patients undergoing surgical removal of an impacted third molar tooth under local anesthesia and intravenous sedation with propofol. Forty-five ASA status 1 dental outpatients were randomly allocated to 2 groups of 22 (group A) and 23 (group B) patients each (n = 45). Group A (T/P) received intravenous tramadol 1.5 mg/kg injected over 2 minutes, followed by a bolus dose of intravenous propofol 0.4 mg/ kg. Maintenance consisted of a continuous infusion of propofol 3 mg/kg/h, with an additional bolus dose of 0.4 mg/kg intravenously 2-3 minutes prior to the infiltration of the local anesthetic solution. Group B (P/P) patients received no tramadol but instead a saline placebo solution and an identical amount of propofol. Overall, in this study, postoperative pain was much better controlled in the group receiving tramadol 1.5 mg/kg intravenously despite there being no significant difference in the dose of propofol administered in both groups. Intravenous tramadol, when given with propofol, did not affect the cardiovascular, respiratory, and sedative effects of propofol. Following tramadol, despite being an opioid, no nausea and vomiting were reported in the early postoperative period, indicating the value of using tramadol with propofol. Thus, this pilot study demonstrated the potential use of intravenous tramadol with propofol in day-case dento-alveolar surgery.

Adult↗
PubMed2004

Effects of intrathecal NMDA and AMPA receptors agonists or antagonists on antinociception of propofol.

AIM: To study the effects of intrathecal (it) agonists and antagonists of N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors and NMDAR1 antisense oligodeoxynucleotides (AS ODN) on the antinociception of propofol. METHODS: Hot-plate test (HPPT) and acetic acid-induced writhing test were used to measure the nociceptive thresholds in mice. The effects of intrathecal NMDA, AMPA, MK-801, NBQX, or NMDAR1 AS ODN on the antinociception of propofol were observed. RESULTS: Propofol (25, 50 mg/kg, ip) displayed an appreciable antinociceptive effect in hot-plate test and acetic acid-induced writhing test. NMDA (12.5, 25 ng, it) or AMPA (1.25, 2.5 ng, it) exhibited no effects on the behavior but decreased HPPT significantly compared with basal HPPT and aCSF group (P<0.05, P<0.01). No effects on behavior and HPPT were obtained in NMDA (6.25 ng, it) or AMPA (0.625 ng, it) groups. NMDA (6.25, 12.5, and 25 ng, it) dose-dependently decreased the HPPT in propofol-treated group. AMPA (1.25, 2.5 ng, it) also decreased HPPT significantly. MK-801 (0.25, 0.5 microg, it) or NBQX (0.25, 0.5 microg, it) groups had no behavioral changes, two antagonists 0.5 microg but not 0.25 microg increased HPPT in conscious or propofol-treated mice. AS ODN (5, 10, and 20 microg, it) groups exhibited dose-dependent increased in HPPT in propofol-treated groups compared with aCSF group (P<0.05, P<0.01). CONCLUSION: Both agonists NMDA and AMPA reversed the antinociception of propofol. MK-801, NBQX, and NMDAR1 AS ODN potentiated the antinociceptive effects of propofol. Propofol produced antinociception through an interaction with spinal NMDA and AMPA receptors in mice.

Analgesics↗
PubMed2004

GABAA receptor partially mediated propofol-induced hyperalgesia at superspinal level and analgesia at spinal cord level in rats.

AIM: To observe effects of propofol on nociceptive response at superspinal and spinal level in rats. METHODS: Two hundreds and fifty-eight Sprague-Dawley male rats were randomized into thirty-two groups. Propofol and bicuculline were microinjected into lateral ventricle (icv), ventrolateral periaqueductal gray (vlPAG), intrathecal (ith), and intraperitoneal (ip). The noxious responses were evaluated by hot plate and formalin test. RESULTS: In hot-plate test, systemic and superspinal administration of propofol (40 mg.kg(-1) ip, 100 microg in 10 microL, icv, and 4 microg in 0.4 microL vlPAG microinjection) produced hyperalgesia (P<0.01). Hyperalgesia induced by vlPAG microinjection of propofol was significantly antagonized by 69.8 %, 71.2 %, 98.8 % at 10, 20, and 30 min by microinjection of bicuculline (10 ng in 0.4 microL, vlPAG) (P<0.01). Analgesia induced by ith propofol (100 microg.10 microL(-1)) was antagonized about 81.3 %, 54.8 %, 80.8 %, and 97.4 % at 10, 20, 30 and 40 min by ith bicuculline (P<0.05). In formalin test, systemic and superspinal administration of propofol (40 mg.kg(-1) ip, 4 microg in 0.4 microL, vlPAG) also produced hyperalgesia (P<0.01). The increased formalin pain scores were antagonized about 57.1 % by bicuculline (10 ng, vlPAG) (P<0.05) at 60 min after formalin injection. The decreased formalin pain scores induced by ith propofol (100 microg in 10 microL) were antagonized about 66.7 % at 30 min by ith bicuculline (P<0.05) after formalin injection. Hyperalgesia produced by ip propofol in both hot plate and formalin test could not be antagonized by vlPAG administration of bicuculline. CONCLUSION: GABAA receptor partly mediated propofol-induced hyperalgesia at superspinal and analgesia at spinal cord in rats.

Analgesia↗
PubMed2004

[Effect of propofol on the activation of nuclear factor-kappa B and expression of inflammatory cytokines in cerebral cortex during transient focal cerebral ischemia-reperfusion: experiment with rats].

OBJECTIVE: To investigate the effect of propofol on the activation of nuclear factor-kappa B (NF-kappa B) and the expression of inflammatory cytokines, such as interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), and intercellular adhesion molecule-1 (ICAM-1) in cerebral cortex during transient focal cerebral ischemia-reperfusion, and to discuss the probable mechanism of its protective effect. METHODS: Ninety male Wistar rats were randomly divided into 3 equal groups: sham operation group undergoing sham operation; ischemia/reperfusion (I/R) group undergoing thread embolism of the left middle cerebral artery occlusion (MCAO) to cause focal ischemia for 2 hours and then undergoing reperfusion; and propofol group undergoing peritoneal injection of propofol 2 hours before the ischemia-reperfusion of MCAO. Then the rats in the 3 groups were re-divided into subgroups of 5 rats, totally 18 subgroups, to be decapitated 2, 3, 6, 12, 24, and 72 hours after reperfusion for the latter 2 groups, and their brains were taken out and fixed. Immunohistochemistry was used to detect the translocation of NF-kappaB in the neurons and the expression of IL-1, TNF-alpha, and ICAM-1 in the brain. Western blotting was used to detect the expression of NF-kappa B. The opposite non-ischemic cortexes were used as controls. RESULTS: Two to 24 hours after the reperfusion NF-kappaB was significantly translocated from the cytoplasm into the nucleus; however, NF-kappa B remained in the cytoplasm of bilateral cortexes in the sham operation groups, and the nonischemic cortexes in the I/R and protofol groups. The translocation of NF-kappa B from cytoplasm into nucleus was significantly inhibited in the ischemic cortex of the propofol group. The expression values of NF-kappa B in the nuclei of ischemic cortexes in the I/R group 2 to 24 hours after reperfusion were significantly higher than those in the sham operation group and the nonischemic cortexes of the I/R and propofol groups (all P < 0.01). The expression values of NF-kappa B in the ischemic cortex of the propofol group 2 to 24 hours after reperfusion was significantly lower than that of the I/R group (all P < 0.05). The expression values of IL-1, TNF-alpha, and ICAM-1 in the ischemic cortexes were significantly higher than that in the cortex of the sham operation group and those in the nonischemic cortexes of the I/R group and propofol group (P < 0.01 or P < 0.05) and the expression values of IL-1, TNF-alpha, and ICAM-1 in the propofol group were all significantly lower than those in the I/R group (all P < 0.05). CONCLUSION: Propofol inhibits the inflammatory reaction by inhibiting the NF-kappa B activation during focal ischemia-reperfusion which may be one of the mechanisms of its neuroprotective function.

Animals↗
PubMed2005

[Elimination half-life of propofol in effect-site of mice].

OBJECTIVE: To study the elimination half-life of propofol in mouse brain. METHODS: One hundred and forty mice were injected with propofol 32 mg/kg through caudal vein. The mice were divided into 14 groups with different time points, i.e. 1, 2, 3, 4, 5, 6, 7, 8, 9 , 10, 15, 30, 45, and 60 min, with 10 mice in each group. The mice were killed to obtain arterial blood by picking off their eyeballs, and their brains by cutting off their heads. The concentrations of propofol in serum and brain were measured by high performance liquid chromatography. The parameters of elimination half-life were calculated by software 3P97. RESULTS: Time to peak concentration of propofol in serum was about 1 min, and time to peak concentration of propofol in brain was about 3 min. The elimination half-life of propofol in brain were (9.6+/-0.5) mins. CONCLUSION: The peak concentrations of propofol in brain was later than it in serum. There is correlation between the concentrations of propofol in blood and in brain. The metabolism of propofol in effect site could be measured accurately by the elimination half-life in brain.

Anesthetics, Intravenous↗
PubMed2005

[Target-controlled infusions of remifentanil and propofol in elderly patients].

OBJECTIVE: To investigate the clinical reliability and feasibility of target-controlled infusion (TCI) with different plasma concentration remifentanil and propofol. METHODS: Thirty ASA I-II patients, > or =65 years old, undergoing selective lower abdominal operation were divided into 3 groups, group A with anesthesia using propofol combined with epidural block, group B with anesthesia using propofol and remifentanil (plasma concentration 4 microg/L), group C with anesthesia using propofol and remifentanil (plasma concentration 7 microg/L). BIS value, heart rate, blood pressure, heart rate variability and so on, were recorded during anesthesia and operation. Radial arterial blood samples for analysis of plasma concentration of propofol were taken during operation. RESULTS: (1) The intubation response of groups B and C was lower than that of group A . (2) The depth of anesthesia was enough during operation (BIS value=45-60). (3) TCI propofol combined with remifentanil didn't lengthen the awaking time of patients; (4) MDPE of target-controlled infusion using propofol with Marsh parameters was 11.17%, MDAPE was 12.16% in Chinese elderly patients. CONCLUSION: Remifentanil with plasma concentration of 4 and 7 microg/L combined with propofol could be safely used during clinical anesthesia of old patient, but monitoring must be strengthened during induction when plasma concentration of remifentanil was 7 microg/L. TCI propofol with Marsh parameters could be applied to Chinese elderly patients safely and efficiently.

Abdomen↗
PubMed1992

[Propofol versus midazolam. Long-term sedation in the intensive care unit].

Sedative-analgesic treatment of patients on long-term artificial ventilation aims at protection from stress related to their disease or therapy. By stabilising both the patient's vital functions and psychological state this treatment may contribute to therapeutic success. The choice of drugs depends primarily on the nature and course of the underlying disease. Midazolam and propofol are available as hypnotics for short-term sedation during the post-operative period. The purpose of this study was to evaluate the effects of both agents on cardiovascular function, cortisol production, lipometabolism, and the recovery period following 24-h sedation. METHODS. Twenty female patients (mean body weight: 72 kg, mean age: 60 years) were randomly assigned to receive either midazolam or propofol over 24 h following major abdominal surgery. Balanced anaesthesia (halothane/O2/N2O/fentanyl) was administered for the surgical procedure. Assisted ventilation was used in all patients during the post-operative sedation period. Sedation depth was maintained at III-IV on the Ramsey scale. On arrival in the intensive care unit (ICU), an initial i.v. bolus of midazolam 0.1 mg/kg or propofol 1 mg/kg was followed by a continuous infusion (midazolam: 0.1 mg/kg.h; propofol: 2 mg/kg.h). Supplementary boluses of one-half the initial dose were given if required. Post-operative analgesia was achieved with 3 mg intravenous piritramide at 2-h intervals. A 7F Swan-Ganz catheter was inserted in the pulmonary artery and haemodynamic and biochemical parameters were monitored at 4-h intervals over 24 h starting 2 h after arrival in the ICU. Catecholamines were measured by high-pressure lipid chromatography (HPLC), cortisol by radioimmunoassay, midazolam by HPLC and ultraviolet detection, and propofol by HPLC and fluorescence detection. Data were calculated as means. The statistical analysis was performed according to the Mann-Whitney test, and significance was accepted for P less than 0.05. RESULTS. On administration of the propofol bolus at the onset of sedation, a decrease in blood pressure was particularly observed in patients with masked hypovolaemia, however, this decrease was easily controlled by volume administration. Independent of the type of sedation, the haemodynamic parameters remained unchanged throughout the observation period. At all times of measurement the mean heart rate was lower in the propofol group (90/min) when compared with the midazolam group (100/min), however, this difference did not reach significance. There were also no significant differences in cardiac index at all times of measurement, although it increased in both groups within the first 12 h by 0.6 l/min.min2. In both groups this increase was associated with a reduction in peripheral resistance and an increase in rectal temperature. To achieve the desired sedation depth, midazolam was administered at a mean dosage of 0.11 mg/kg.h and propofol at 1.9 mg/kg.h. Catecholamine levels decreased in both groups within the first 8 h: after 8 h of sedation the plasma levels of noradrenaline and adrenaline were 525 and 65 pg/ml, respectively, in the midazolam group and 327 and 51 pg/ml in the propofol group. (ABSTRACT TRUNCATED AT 400 WORDS)

Critical Care↗
PubMed2006

[Clinical observation of propofol combined with flurbiprofen axetil for induced abortion anesthesia].

OBJECTIVE: To observe the effect of propofol combined with flurbiprofen axetil for abortion anesthesia. METHODS: Eighty ASA I - II induced abortion patients were randomly divided into 4 groups. Group I was administrated 1 microg/kg with tramadol first, after 10 minutes with 2 mg/kg propofol. Group II was administrated with 1 mg/kg tramadol first, after 10 minutes with 2 mg/kg propofol. Group III was administrated flurbiprofen axetil 50 mg first, after 10 minutes 2 mg/kg propofol. Group IV was administrated propofol 2 mg/kg. The speed of intravenous injection of propofol was 100 mg/min in all groups. Induction time, recovery time, propofol dosage, HR, BP, SpO2, and side effect were recorded. The anesthesia effect was judged by operation doctors. RESULTS: Propofol consumption and awaken time in Group IV was more than those of other groups. The number of patients in Group I with minimum value of SpO2 in the operation (85% - 90% or SpO2<85%) was higher than that of other groups (P<0.05). The number of patients in Group I and II with the tongue falling backwards during anesthesia, with post-anesthesia nausea and vomit was higher than that of other groups (P<0.05). Incidences of post-anesthesia excitement or delirium were higher than other groups. Fewer patients in Group IV showed a good level anesthesia effect than other groups. The post-operative hypogastric pain of VAS score (0 - 2) in Group III was better than others. CONCLUSION: Propofol combined with flurbiprofen axetil gives more efficient anesthesia for induced abortion patients in gynecology department. It can not only have satisfactory anesthesia effect, but also decrease adverse effects and obtain better depression effects to the post-operative hypogastric pain.

Abortion, Induced↗
PubMed2006

Do the lungs contribute to propofol elimination in patients during orthotopic liver transplantation without veno-venous bypass?

BACKGROUND: The clearance of propofol is very rapid, and its transformation takes place mainly in the liver. Some reports indicated extrahepatic clearance of the drug and that the lungs are the likely place where the process occurs. This study was undertaken to compare the plasma concentrations of propofol both in the pulmonary and radial arteries after constant infusion during the dissection, anhepatic and reperfusion phases of orthotopic liver transplantation (OLT) without veno-venous bypass, attempting to investigate extrahepatic clearance and to determine whether the human lungs take part in the elimination of propofol. METHODS: Fifteen patients undergoing OLT without veno-venous bypass were enrolled in the study, and propofol was infused via a forearm vein at a rate of 2 mg x kg-1 x h-1. Blood samples were simultaneously collected from pulmonary and radial arteries at the end of the first hepatic portal dissection (T0), at the clamping of the portal vein (T1), 30, and 60 minutes after the beginning of the anhepatic phase (T2, T3), and 30, 60, and 120 minutes after the unclamping of the new liver (T4, T5, T6). Plasma propofol concentrations were measured using a reversed-phase, high-performance liquid chromatographic method with fluorescence detection. RESULTS: The concentrations of plasma propofol in the pulmonary and radial arteries at T2 and T3 rose significantly compared with T0 and T1 (P<0.01) respectively. After reperfusion, the drug concentrations at T4, T5 and T6 decreased significantly compared with T2, T3 (P<0.01) respectively. There were no significant differences in plasma propofol concentrations between the pulmonary and radial arteries at any time points. CONCLUSIONS: Propofol is eliminated mainly by the liver, and also by extrahepatic organs. The lungs seem to be not a major site contributing to the extrahepatic metabolism of propofol in humans.

Adult↗
PubMedDate not supplied

BIS - AAI and clinical measures during propofol target controlled infusion with Schnider's pharmacokinetic model.

AIM: The A-line autoregressive index (AAI) and the Bispectral Index Score (BIS) are two commercially available indexes of anesthetic depth widely used in clinical practice. The aim of the current study was to compare the accuracy of AAI, BIS, Schnider's predicted effect-site concentration of propofol (Ce propofol) to assess depth of anesthesia. METHODS: Forty-four patients scheduled for major elective abdominal surgery received target effect-site controlled infusion of propofol. Target effect-site (Ce propofol) was started at 1.5 mug/mL and increased every 4 min by 1.0 microg/mL until 5.5 microg/mL were achieved. At every step sedation level was estimated, using AAI, BIS, Observer's Assessment of Alertness/Sedation scale (OAA/S), loss of eyelash reflex and Ce propofol. RESULTS: We enrolled 44 patients, 20 males and 24 females, ASA I/II 18/26, 48+/-10 years, 68.2+/-9 kg, 165+/-7.1 cm, body mass index (BMI) 25+/-3.5. At increasing Ce propofol BIS-AAI values decreased progressively (BIS range 97-38) (AAI range 97-17). Values of BIS < or = 50, of AAI < or = 48 and of Ce propofol > or = 5.1 resulted in OAA/S=0, while values of BIS < or = 62, AAI < or = 53 and Ce propofol < or = 3.5 resulted in OAA/S=2. Loss of eyelash reflex occurred when values were BIS < or = 64 and AAI < or 61. CONCLUSION: BIS, AAI, propofol site effect concentration revealed information on sedation level and consciousness but no gold standard yet exists because of consistent overlap between ''conscious'' and ''not conscious'' states.

Acoustic Stimulation↗