title: Influence of a modified propofol equilibration rate constant (k(e0)) on the effect-site concentration at loss and recovery of consciousness with the Marsh model.
abstract: This study compared the predicted effect-site concentration of propofol at loss and recovery of consciousness when using target-controlled infusion devices with the same pharmacokinetic model (Marsh) but a different plasma effect-site equilibration rate constant (ke0 ), the Diprifusor(TM) (ke0 0.26 min(-1) ) and Base Primea™ (ke0 1.21 min(-1) ). We studied 60 female patients undergoing minor gynaecological surgery under general anaesthesia. Although the total dose of propofol and time until loss of consciousness were comparable, the effect-site concentration at loss of consciousness was significantly lower with the Diprifusor than with the Base Primea (1.2 (0.3) μg.ml(-1) vs 4.5 (0.9) μg.ml(-1) , respectively, p < 0.001). The effect-site concentration at recovery of consciousness was significantly higher with the Diprifusor than with the Base Primea (1.8 (0.4) μg.ml(-1) vs 1.5 (0.2) μg.ml(-1) , respectively, p = 0.01). In conclusion, the effect-site concentration of propofol differs depending on the ke0 , despite the use of the same pharmacokinetic model. Therefore, the ke0 should be considered when predicting loss and recovery of consciousness based on the effect-site concentration of propofol.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Seo
authors.forename: E K
authors.initials: EK
authors.lastname: Goo
authors.forename: I A
authors.initials: IA
authors.lastname: Song
authors.forename: S H
authors.initials: SH
authors.lastname: Park
authors.forename: H P
authors.initials: HP
authors.lastname: Park
authors.forename: Y T
authors.initials: YT
authors.lastname: Jeon
authors.forename: J W
authors.initials: JW
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods; D018686:Anesthetics, Intravenous / Q000097:blood / Q000493:pharmacokinetics*; D003243:Consciousness / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D008954:Models, Biological; D015742:Propofol / Q000097:blood / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol