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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
Author(s) -
Seo J. H.,
Goo E. K.,
Song I. A.,
Park S. H.,
Park H. P.,
Jeon Y. T.,
Hwang J. W.
Publication year - 2013
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12419
Subject(s) - propofol , anesthesia , medicine , pharmacokinetics , plasma concentration , consciousness , target controlled infusion , zoology , pharmacology , biology , neuroscience , remifentanil
Summary 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 (k e0 ), the Diprifusor TM (k e0 0.26 min −1 ) and Base Primea™ (k e0 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 k e0 , despite the use of the same pharmacokinetic model. Therefore, the k e0 should be considered when predicting loss and recovery of consciousness based on the effect‐site concentration of propofol.