Effect-site concentration of propofol for recovery of consciousness is virtually independent of fentanyl effect-site concentration.

Abstract:

UNLABELLED:Fentanyl reduces the amount of propofol necessary to prevent responses to surgical stimuli. However, opioids have relatively little effect on consciousness. We, therefore, tested the hypothesis that fentanyl minimally alters the effect-site concentration of propofol associated with awakening. Fifty women having gynecologic laparotomy with propofol anesthesia were randomly allocated into the following target effect-site fentanyl concentrations: 0.8, 1.0, 1.4, 2.0, and 3.0 ng/mL. Fentanyl was continued at the designated rate through the initial postoperative phase. The propofol effect-site concentration associated with eye opening in response to verbal command was regarded as the awakening concentration. The estimated propofol effect-site concentrations at awakening did not differ significantly among the groups and were 1.9 +/- 0.5 micro g/mL with a fentanyl effect-site concentration of 0.8 ng/mL; 1.6 +/- 0.4 micro g/mL with 1.0 ng/mL of fentanyl; 1.6 +/- 0.2 micro g/mL with 1.4 ng/mL of fentanyl; 1.7 +/- 0.4 micro g/mL with 2.0 ng/mL of fentanyl; and 1.6 +/- 0.34 micro g/mL with 3.0 ng/mL of fentanyl (mean +/- SD). Seventy percent of the subjects in the 0.8 ng/mL fentanyl group spontaneously complained of pain, whereas none of the patients in the 2 or 3 ng/mL groups did. Five (56%) of 9 women in the 3 ng/mL group had a postoperative respiratory rate <6 breaths/min. Heart rate in one of these women decreased to <40 bpm. These data suggest that the optimal fentanyl effect-site concentration in patients recovering from gynecologic laparoscopy is between 1.4 and 2.0 ng/mL. IMPLICATIONS:The effect-site concentration for propofol at awakening was virtually independent of the fentanyl effect-site concentration over the range of 0.8 to 3.0 ng/mL; however, 0.8 ng/mL of fentanyl was associated with inadequate postoperative analgesia, and 3.0 ng/mL of fentanyl was associated with respiratory toxicity. The optimal postoperative fentanyl effect-site concentration during recovery from propofol general anesthesia for laparotomy thus appears to be near 2 ng/mL.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Iwakiri H,Nagata O,Matsukawa T,Ozaki M,Sessler DI

doi

10.1213/01.ane.0000062772.28479.2b

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

1651-5, table of contents

issue

6

eissn

0003-2999

issn

1526-7598

journal_volume

96

pub_type

临床试验,杂志文章,随机对照试验
  • Hemodynamic response to caudal epidural clonidine in a pediatric cardiac patient.

    abstract:IMPLICATIONS:Postoperative management of sedation and analgesia in pediatric cardiac patients presents many challenges. This case report describes a child who experienced dramatic clinical improvement with the postoperative use of caudal morphine and clonidine after conventional therapy had failed. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200301000-00019

    authors: Diaz LK,Cantu F

    更新日期:2003-01-01 00:00:00

  • Single versus staged epidural injections of 0.75% bupivacaine: pharmacokinetic and pharmacodynamic effects.

    abstract::Epidural anesthesia may be performed as a single injection or by staged doses. Thirty patients undergoing primary total hip replacement were randomly assigned to have epidural anesthesia using a single injection or a staged technique with 25 mL of 0.75% bupivacaine. Arterial plasma bupivacaine concentrations were sign...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199408000-00019

    authors: Sharrock NE,Mineo R,Stanton J,Ennis WJ 3rd,Urmey WF,Arthur GR

    更新日期:1994-08-01 00:00:00

  • Distribution of Extreme Vital Signs and Complete Blood Count Values of Healthy Parturients: A Retrospective Database Analysis and Review of the Literature.

    abstract:BACKGROUND:The impact of physiological adjustments throughout pregnancy on maternal vital signs and laboratory values has yet to be fully defined. The present study was designed to determine the normal range of these parameters among healthy pregnant women during the peripartum period. METHODS:This is a retrospective ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000003866

    authors: Gat R,Hadar E,Orbach-Zinger S,Shochat T,Kushnir S,Einav S

    更新日期:2019-12-01 00:00:00

  • Differential suppression of intracranial self-stimulation, food-maintained operant responding, and open field activity by paw incision and spinal nerve ligation in rats.

    abstract:BACKGROUND:Detection of ongoing spontaneous pain behaviors in laboratory animals remains a research challenge. Most preclinical pain studies measure elicited behavioral responses to an external noxious stimulus; however, ongoing spontaneous pain in humans and animals may be unrelated to hypersensitivity, and likely dim...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000119

    authors: Ewan EE,Martin TJ

    更新日期:2014-04-01 00:00:00

  • Activity changes in rat raphe magnus neurons at different concentrations of fentanyl in vitro.

    abstract::The nucleus raphe magnus (NRM) is an important descending pain inhibitory system. We postulated that the analgesic action of supraspinally administered opiates results from increased descending inhibitory control of the NRM. We tested whether fentanyl activates NRM neurons in the rat slice preparation using extra-cell...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199505000-00007

    authors: Ohta Y,Alojado ME,Kemmotsu O

    更新日期:1995-05-01 00:00:00

  • The efficiency of an autotransfusion system for tumor cell removal from blood salvaged during cancer surgery.

    abstract::The efficiency of a gravity-dependent autotransfusion system (ATS) for filtering tumor cells from blood was examined under laboratory and clinical conditions. In laboratory studies, reconstituted whole blood was seeded with known numbers of cultured A431 human vulva carcinoma cells then filtered through the ATS. Cance...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199406000-00017

    authors: Karczewski DM,Lema MJ,Glaves D

    更新日期:1994-06-01 00:00:00

  • The effect of amitriptyline, gabapentin, and carbamazepine on morphine-induced hypercarbia in rabbits.

    abstract:BACKGROUND:Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whet...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31817e6e53

    authors: Kozer E,Levichek Z,Hoshino N,Kapur B,Leombruno J,Taguchi N,Garcia-Bournissen F,Koren G,Ito S

    更新日期:2008-10-01 00:00:00

  • Adverse cardiac outcomes after noncardiac surgery in patients with prior percutaneous transluminal coronary angioplasty.

    abstract:UNLABELLED:In this retrospective cohort study, we compared adverse cardiac outcomes after noncardiac surgery among patients with prior percutaneous transluminal coronary angioplasty (PTCA), patients with nonrevascularized coronary artery disease (CAD), and normal controls. Inpatient hospital discharge abstracts from al...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199909000-00003

    authors: Posner KL,Van Norman GA,Chan V

    更新日期:1999-09-01 00:00:00

  • The protective effects of volatile anesthestics against the bronchoconstriction induced by an allergic reaction in sensitized rabbit pups.

    abstract:BACKGROUND:Volatile inhaled anesthetics exert a differential protective effect against bronchospasm development after cholinergic stimulation. However, their ability to inhibit the adverse respiratory consequences of an anaphylactic reaction after exposure to an allergen has not been characterized. We therefore compare...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31828e5ccf

    authors: Lele E,Petak F,Carnesecchi S,Virag K,Argiroffo CB,Habre W

    更新日期:2013-06-01 00:00:00

  • The effects of desflurane on cardiac function as measured by conductance volumetry in swine.

    abstract:UNLABELLED:The purpose of the investigation was to assess the effects of desflurane (DES) on left ventricular heart function during basal barbiturate anesthesia in a closed-pericardium, closed-chest acute swine model. The study was performed in 11 normoventilated adult pigs. Hemodynamic measurements were obtained using...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199809000-00003

    authors: Sundeman H,Haney M,Broomé M,Häggmark S,Johansson G,Winsö O,Biber B

    更新日期:1998-09-01 00:00:00

  • The utility of tracheal temperature monitoring.

    abstract::Tracheal temperature--the temperature of the tracheal wall--is believed to reflect the core temperature. The trachea reacts quickly to temperature changes because it is surrounded by various large arteries and veins. Using the blood temperature from the cardiopulmonary bypass (CPB) and the jugular vein temperature as ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199304000-00020

    authors: Yamakage M,Kawana S,Watanabe H,Namiki A

    更新日期:1993-04-01 00:00:00

  • The efficacy of thoracic epidural neostigmine infusion after thoracotomy.

    abstract::Few anesthesia studies have explored perioperative continuous epidural infusion of neostigmine. We examined such a regimen in thoracotomy patients. Ninety patients were randomized to one of three groups in this double-blind trial. Before anesthesia induction, an epidural catheter was inserted in all patients at T5-8 l...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000184812.94185.b3

    authors: Chia YY,Chang TH,Liu K,Chang HC,Ko NH,Wang YM

    更新日期:2006-01-01 00:00:00

  • Beta-adrenergic receptor function is acutely altered in surgical patients.

    abstract::Catecholamine-induced desensitization of beta-adrenergic receptors resulting in hyporesponsiveness to further stimulation has been frequently reported after an increase in endogenous catecholamines. To examine the possibility of beta-adrenoceptor desensitization due to intraoperative adrenergic activation (surgical st...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199007000-00001

    authors: Marty J,Nimier M,Rocchiccioli C,Mantz J,Luscombe F,Henzel D,Loiseau A,Desmonts JM

    更新日期:1990-07-01 00:00:00

  • Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training.

    abstract:BACKGROUND:Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemas...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000003678

    authors: van Emden MW,Geurts JJ,Schober P,Schwarte LA

    更新日期:2018-10-01 00:00:00

  • Blood Substitutes and Oxygen Therapeutics: A Review.

    abstract::Despite the exhaustive search for an acceptable substitute to erythrocyte transfusion, neither chemical-based products such as perfluorocarbons nor hemoglobin-based oxygen carriers have succeeded in providing a reasonable alternative to allogeneic blood transfusion. However, there remain scenarios in which blood trans...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000003957

    authors: Jahr JS,Guinn NR,Lowery DR,Shore-Lesserson L,Shander A

    更新日期:2021-01-01 00:00:00

  • Myocardial metabolism and hemodynamic responses with isoflurane anesthesia for coronary arterial surgery.

    abstract::Isoflurane-oxygen was given for induction and maintenance of anesthesia to ten patients having coronary artery bypass grafts. All had preserved ventricular function without hypertension or other cardiac lesions; treatment with beta-blocking drugs was maintained until the operation in all patients. Cardiac output, arte...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Moffitt EA,Barker RA,Glenn JJ,Imrie DD,DelCampo C,Landymore RW,Kinley CE,Murphy DA

    更新日期:1986-01-01 00:00:00

  • The interaction of FK409, a novel nitric oxide releaser, and peripherally administered morphine during experimental inflammation.

    abstract:UNLABELLED:Nitric oxide (NO) may play an important role in central and peripheral nociceptive processes. However, its contribution to peripheral antinociception is still not clear. In the present study, we investigated the effect of peripherally administered FK409, a spontaneous NO releaser, and its interaction with pe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199802000-00028

    authors: Nozaki-Taguchi N,Yamamoto T

    更新日期:1998-02-01 00:00:00

  • Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts.

    abstract::Repeated conventional tracheal intubation attempts may contribute to patient morbidity. Critically-ill patients (n = 2833) suffering from cardiovascular, pulmonary, metabolic, neurologic, or trauma-related deterioration were entered into an emergency intubation quality improvement database. This practice analysis was ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000122825.04923.15

    authors: Mort TC

    更新日期:2004-08-01 00:00:00

  • Transient neurologic syndrome in one thousand forty-five patients after 3% lidocaine spinal anesthesia.

    abstract:UNLABELLED:Recent reports have discussed the potential risk of transient radicular irritation (TRI) after spinal anesthesia with lidocaine. Because we have not encountered such neurologic sequelae with the high incidence reported, we prospectively examined the incidence of TRI after spinal anesthesia with lidocaine. On...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199805000-00022

    authors: Morisaki H,Masuda J,Kaneko S,Matsushima M,Takeda J

    更新日期:1998-05-01 00:00:00

  • Doxacurium and mivacurium do not trigger malignant hyperthermia in susceptible swine.

    abstract::The role of succinylcholine in the precipitation of malignant hyperthermia (MH) necessitates the testing of new neuromuscular relaxants for their ability to trigger MH in MH-susceptible swine before general human use. We tested doxacurium and mivacurium, two new nondepolarizing bis-benzylisoquinolinium neuromuscular r...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199009000-00012

    authors: Sufit RL,Kreul JF,Bellay YM,Helmer P,Brunson DB,Will J

    更新日期:1990-09-01 00:00:00

  • Convective warming therapy does not increase the risk of wound contamination in the operating room.

    abstract::Although convective warming therapy is effective in preventing hypothermia in anesthetized patients, little is known concerning the potential risks of its use. Hence, this balanced cross-over study was designed to determine if the use of convective warming therapy increased the risk of wound contamination. For 4 h, ei...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199301000-00009

    authors: Zink RS,Iaizzo PA

    更新日期:1993-01-01 00:00:00

  • A long-term clinical evaluation of autoflow during assist-controlled ventilation: a randomized controlled trial.

    abstract:BACKGROUND:Many new mechanical ventilation modes are proposed without any clinical evaluation. "Dual-controlled" modes, such as AutoFlow™, are supposed to improve patient- ventilator interfacing and could lead to fewer alarms. We performed a long-term clinical evaluation of the efficacy and safety of AutoFlow during as...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181f00015

    authors: Lasocki S,Labat F,Plantefeve G,Desmard M,Mentec H

    更新日期:2010-10-01 00:00:00

  • The optimal length of insertion of central venous catheters for pediatric patients.

    abstract:UNLABELLED:Incorrect positioning of central venous catheters (CVC) in infants and children may lead to serious complications such as perforation of the heart or great vessels. CVC position is not usually assessed until the first postoperative chest radiograph, potentially leaving malposition undetected for several hour...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200110000-00016

    authors: Andropoulos DB,Bent ST,Skjonsby B,Stayer SA

    更新日期:2001-10-01 00:00:00

  • The care of patients with phantom limb pain in a pain clinic.

    abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197711000-00019

    authors: Blankenbaker WL

    更新日期:1977-11-01 00:00:00

  • A spray catheter technique for pleural anesthesia: a novel method for pain control before talc poudrage.

    abstract:BACKGROUND:Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS:Patients were premedicated with...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000249046.02025.ef

    authors: Lee P,Colt HG

    更新日期:2007-01-01 00:00:00

  • Intrathecal injection of the peptide myr-NR2B9c attenuates bone cancer pain via perturbing N-methyl-D-aspartate receptor-PSD-95 protein interactions in mice.

    abstract:BACKGROUND:N-methyl-D-aspartate receptor (NMDARs)-dependent central sensitization plays an important role in cancer pain. Binding of NMDAR subunit 2B (NR2B) by postsynaptic density protein-95 (PSD-95) can couple NMDAR activity to intracellular enzymes, such as neuronal nitric oxide synthase (nNOS), facilitate downstrea...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000202

    authors: Liu Y,Cui X,Sun YE,Yang X,Ni K,Zhou Y,Ma Z,Gu X

    更新日期:2014-06-01 00:00:00

  • Point-of-Care Fibrinogen Testing in Pregnancy.

    abstract::Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8-51.9) with a st...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003301

    authors: Katz D,Hamburger J,Batt D,Zahn J,Beilin Y

    更新日期:2019-09-01 00:00:00

  • Safety and Efficacy of the Combination of Propofol and Ketamine for Procedural Sedation/Anesthesia in the Pediatric Population: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Drugs such as propofol and ketamine are used alone or in combination to provide sedation for medical procedures in children. The purpose of this systematic review was to compare the safety and effectiveness of propofol and ketamine to other drug regimens. METHODS:We searched Medline, Embase, Cochrane Centra...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004967

    authors: Hayes JA,Aljuhani T,De Oliveira K,Johnston BC

    更新日期:2020-07-07 00:00:00

  • Nonhalogenated anesthetic alkanes and perhalogenated nonimmobilizing alkanes inhibit alpha(4)beta(2) neuronal nicotinic acetylcholine receptors.

    abstract:UNLABELLED:The nonhalogenated anesthetic alkanes, cyclopropane and butane, do not enhance gamma-aminobutyric acid-elicited GABAergic currents, suggesting that these agents produce anesthesia via interactions with other molecular targets. Perhalogenated nonimmobilizing alkanes, such as 1,2-dichlorohexafluorocyclobutane ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200209000-00015

    authors: Raines DE,Claycomb RJ,Forman SA

    更新日期:2002-09-01 00:00:00

  • Exposure to halothane and enflurane affects learning function of murine progeny.

    abstract::This study was conducted to assess the learning function of murine progeny born of mothers that had received either 1% or 2% halothane or 2% or 4% enflurane, on days 6 and 10 or days 14 and 17 or gestation. Their timed performance at the age of 6 to 7 weeks was compared in a maze with that of control mice of similar a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Chalon J,Tang CK,Ramanathan S,Eisner M,Katz R,Turndorf H

    更新日期:1981-11-01 00:00:00