title: Propofol concentration to induce general anesthesia in children aged 3-11 years with the Kataria effect-site model.
abstract: BACKGROUND
  The propofol pharmacokinetic model derived by Kataria et al. was recently modified to perform effect-site target-controlled infusion (TCI). Effect-site concentration (Ce) targets to induce general anesthesia with this model in children have not been described. The aim of this study was to identify propofol Ce targets associated with success rates of 50% (Ce50) and 95% (Ce95) among children 3-11 years of age.
  
  
  METHODS
  Forty-two children were assigned to one of seven groups of six patients each according to propofol target Ce. After fentanyl administration propofol TCI was started with an assigned Ce target. A successful response was defined as loss of eyelash reflex and bispectral index < 50, 45 s after reaching the assigned Ce. Logistic regression analysis was performed to calculate propofol Ce50 and Ce95.
  
  
  RESULTS
  Twenty-eight children had a successful response with the assigned propofol Ce. In these patients, a significant decrease in mean arterial blood pressure (79-59, P < 0.0001) and in heart rate (95-83, P < 0.0001) was observed. Propofol Ce and age showed a statistically significant effect in the logistic regression model. The overall calculated propofol Ce50 and Ce95 were 3.8 μg·ml(-1) (95% CI: 3.1-4.4 μg·ml(-1) ) and 6.1 μg·ml(-1) (95% CI: 4.6-7.6 μg·ml(-1) ), respectively.
  
  
  CONCLUSIONS
  Our results identified useful propofol targets to be used with the Kataria effect-site model to induce anesthesia in children between 3 and 11 years. The recommended targets should be reduced progressively with increasing age most probably due to PK model misspecifications.
authors.affiliation: Department of Anesthesiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fuentes
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cortínez
authors.forename: Mauricio
authors.initials: M
authors.lastname: Ibacache
authors.forename: Mario
authors.initials: M
authors.lastname: Concha
authors.forename: Hernán
authors.initials: H
authors.lastname: Muñoz
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D015742:Propofol / Q000493:pharmacokinetics*; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: Propofol; children; pharmacokinetics; target-controlled infusion; total intravenous anesthesia