Estimation of the plasma effect site equilibration rate constant of sufentanil in children using the time to peak effect of heart rate and blood pressure.
OBJECTIVE
Although targeting the effect site concentration may offer advantages over the traditional forms of administering intravenous anesthetics, it is not applicable for sufentanil in children because its plasma effect site equilibration rate constant (ke0) is not known yet. We estimated ke0 of sufentanil in children using the time to peak effect (t peak) method.


METHODS
Under general anesthesia, sufentanil t peak was measured after administration of a submaximal bolus dose by means of the decrease in heart rate, blood pressure and calculated approximate entropy (ApEn) of electroencephalogram in 105 children (age range: 3-11 years). ke0 was estimated using t peak and known sufentanil pharmacokinetic parameters in normal children.


RESULTS
The mean t peaks were measured as 44 ± 22 s and 227 ± 91 s by heart rate and by mean blood pressure respectively. The estimated ke0 were 5.16/min and 0.49/min by heart rate and blood pressure respectively. t peak could not be measured using the ApEn, thus ke0 could not be calculated by ApEn in children.


CONCLUSIONS
Shorter measured sufentanil t peak by heart rate compared to blood pressure indicate that the heart rate decrease faster than decreasing of blood pressure. Moreover, the calculated sufentanil ke0 in children depends on the pharmacodynamics parameters.
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
In-Kyung
IK
Song
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Ji-Hyun
JH
Lee
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
SungAe
S
Jung
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Jin-Tae
JT
Kim
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Hee-Soo
HS
Kim
D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage* / Q000493:pharmacokinetics; D013997:Time Factors
D018686:Anesthetics, Intravenous; D017409:Sufentanil
Children; plasma effect site equilibration rate constant; sufentanil