[Anesthetic management of a hyper-obese patient by target-controlled infusion (TCI) of propofol and fentanyl].
We gave total intravenous anesthesia to an over-100% hyper-obese patient using target-controlled infusion (TCI) of propofol and fentanyl. To keep him asleep, we maintained his BIS in a range of 40 to 60 by adjusting the target concentration of propofol. For the target concentration of fentanyl, we chose 2 ng.ml-1 at incision and 1.6 ng.ml-1 during the operation. At the patient's emergence from anesthesia, his estimated blood concentration of propofol was 1.51 micrograms.ml-1 and his BIS was 80. The relationship between BIS value and effect-site concentration of propofol was almost the same as that assessed in ordinary adults of a normal weight. We conclude that the estimated concentration of propofol is a good indicator of the effect of propofol and that TCI is a useful technique in obese patients as well as in ordinary adults.
Saijo
H
H
Department of Oral Surgery, University of Tokyo Branch Hospital, Tokyo 112-0015.
Nagata
O
O
Kitamura
T
T
Fujiwara
H
H
Hagiwara-Oguchi
K
K
Ide
Y
Y
Tagami
M
M
Hanaoka
K
K
D000328:Adult; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous; D005283:Fentanyl; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009767:Obesity, Morbid / Q000150:complications*; D015742:Propofol; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy
D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol