Sensitivity to propofol in the elderly.
Two studies were carried out on 609 fit, unpremedicated patients to assess the influence of patient age on the response to the rapidly-acting hindered phenol, propofol, which is being evaluated for induction of anaesthesia. In the first study, 1.25 mg/kg was injected over 20 seconds followed by 10-mg increments every 15 seconds until loss of verbal contact. This showed a great individual variation in response to the drug. A reduction in the 'induction' dose was found in elderly patients, which became marked around 60 years. In the second (340), doses ranging from 1.5-3.0 mg/kg in patients under 60 years and 1.25-2.25 mg/kg in those over 60 years were injected as a bolus over 20 seconds. Doses of 2.25-2.5 mg/kg were required to induce anaesthesia in patients under 60 years, whilst 1.5-1.75 mg/kg was adequate in those over 60 years. Side effects were more marked with the rapid injection and doses in excess of 1.75 mg/kg caused significant hypotension and apnoea in the elderly. These studies reveal marked sensitivity to propofol in the elderly with respect to both induction dose and acute toxicity.
D000328:Adult; D000367:Age Factors; D000368:Aged; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000009:adverse effects*; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010636:Phenols / Q000008:administration & dosage / Q000009:adverse effects*; D015742:Propofol
D000777:Anesthetics; D010636:Phenols; D015742:Propofol