title: Chronic alcoholism increases the induction dose of propofol.
abstract: BACKGROUND
  The present study was designed to investigate the possible effect of chronic alcohol intake on propofol and remifentanil requirements, which was determined by quantifying the 50% (EC(50) ) and 95% (EC(95) ) effective effect-site concentrations for propofol and remifentanil at loss of consciousness (LOC) and after a painful stimulus.
  
  
  METHODS
  Thirty male patients (alcoholic group; n = 30) with chronic alcoholism and 30 patients (control group; n = 30) with a history of small alcohol intake were anaesthetized with propofol and remifentanil by target-controlled infusion. The predicted drug concentrations and Bispectral Index (BIS) values were recorded at LOC and after no response to painful stimuli.
  
  
  RESULTS
  The EC(50)  and EC(95)  of propofol at LOC in alcoholic group were 3.15 [95% confidence interval (CI), 2.77-3.37] and 4.05 (95% CI, 3.18-5.26) μg/ml, respectively, and those of the control group were 2.21 (95% CI, 1.92-2.86) and 3.04 (95% CI, 2.45-4.64) μg/ml, respectively. The EC(50)  and EC(95)  of remifentanil measured after no response to painful stimuli in the alcoholic group were 3.02 (95% CI, 2.70-3.38) and 4.98 (95% CI, 4.56-5.89) ng/ml, respectively, and those of the control group were 2.95 (95% CI, 2.68-3.33) and 4.86 (95% CI, 4.55-5.92) ng/ml, respectively. The EC(50)  and EC(95)  values of propofol at LOC in the control group were significantly lower than that of the alcoholic group.
  
  
  CONCLUSIONS
  These findings suggest that the induction dose requirements of propofol are increased in alcoholic patients anaesthetized with propofol and remifentanil administered by target controlled infusion.
authors.affiliation: Department of Anesthesiology, Shanghai Minhang District Central Hospital, China.
authors.forename: C
authors.initials: C
authors.lastname: Liang
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: W
authors.initials: W
authors.lastname: Gu
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: Z
authors.initials: Z
authors.lastname: Xue
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000378:metabolism*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage*; D011963:Receptors, GABA-A / Q000187:drug effects; D000077208:Remifentanil
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D011963:Receptors, GABA-A; D000077208:Remifentanil; D015742:Propofol