Abstract:
:Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. By Audrey Shafer, Van A. Doze, Steven L. Shafer, and Paul F. White. Anesthesiology 1988; 69:348-56. Reprinted with permission.The pharmacokinetic and pharmacodynamic properties of propofol (Diprivan) were studied in 50 elective surgical patients. Propofol was administered as a bolus dose, 2 mg/kg iv, followed by a variable-rate infusion, 0-20 mg/min, and intermittent supplemental boluses, 10-20 mg iv, as part of a general anesthetic technique that included nitrous oxide, meperidine, and muscle relaxants. For a majority of the patients (n = 30), the pharmacokinetics of propofol were best described by a two-compartment model. The propofol mean total body clearance rate was 2.09 +/- 0.65 l/min (mean +/- SD), the volume of distribution at steady state was 159 +/- 57 l, and the elimination half-life was 116 +/- 34 min. Elderly patients (patients older than 60 yr vs. those younger than 60 yr) had significantly decreased clearance rates (1.58 +/- 0.42 vs. 2.19 +/- 0.64 l/min), whereas women (vs. men) had greater clearance rates (33 +/- 8 vs. 26 +/- 7 ml x kg x min ) and volumes of distribution (2.50 +/- 0.81 vs. 2.05 +/- 0.65 l/kg). Patients undergoing major (intraabdominal) surgery had longer elimination half-life values (136 +/- 40 vs. 108 +/- 29 min). Patients required an average blood propofol concentration of 4.05 +/- 1.01 micrograms/ml for major surgery and 2.97 +/- 1.07 micrograms/ml for nonmajor surgery. Blood propofol concentrations at which 50% of patients (EC50) were awake and oriented after surgery were 1.07 and 0.95 microgram/ml, respectively. Psychomotor performance returned to baseline at blood propofol concentrations of 0.38-0.43 microgram/ml (EC50). This clinical study demonstrates the feasibility of performing pharmacokinetic and pharmacodynamic analyses when complex infusion and bolus regimens are used for administering iv anesthetics.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
White PFdoi
10.1097/ALN.0b013e31818ddba8subject
Has Abstractpub_date
2008-12-01 00:00:00pages
1132-6issue
6eissn
0003-3022issn
1528-1175pii
00000542-200812000-00027journal_volume
109pub_type
古典文章,评论,杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Povidone iodine (PI) solution is used commonly for skin disinfection before epidural and spinal anesthesia. Although there have been reports indicating the presence of microbial contaminants in PI solution, none have evaluated the prevalence of PI contamination. The aims of this study were to assess the freq...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199803000-00017
更新日期:1998-03-01 00:00:00
abstract::The authors evaluated the systemic and cerebral hemodynamic and metabolic effects of 1 h of hypotension to a mean arterial pressure of either 50 mmHg or 40 mmHg induced by intravenous adenosine or ATP in dogs maintained on 70% nitrous oxide and 0.1% halothane. Following the hypotensive period, brain biopsy specimens w...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198504000-00010
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:Although automated closed-loop control systems may improve quality of care, their safety must be proved under extreme control conditions. This study describes a simulation methodology to test automated controllers and its application in a comparison of two published controllers for Bispectral Index (BIS)-gui...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200403000-00026
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Basal cytotoxic activity of NK cells, a subtype of lymphocytes involved in the nonspecific immune response to viruses, tumors, and some bacteria, is altered in the postoperative period. The current study examines the effects of halothane and isoflurane on interferon-induced stimulation of NK cell cytotoxicit...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199304000-00013
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Because ephedrine infusion (2 mg/min) does not adequately prevent spinal hypotension during cesarean delivery, the authors investigated whether adding phenylephrine would improve its efficacy. METHODS:Thirty-nine parturients with American Society of Anesthesiologists physical status I-II who were scheduled ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200109000-00020
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods o...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000296069.00566.16
更新日期:2008-01-01 00:00:00
abstract::Intravenous lidocaine has been shown to relieve acute postoperative pain and chronic neuropathic pain. It is not known whether analgesia produced by 2-10 micrograms/ml plasma concentrations of lidocaine is due to an effect on peripheral-pain-transducing nerves or to central nervous system effects. The current study ex...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199105000-00020
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:The effects of thoracic epidural anesthesia (TEA) on myocardial repolarization and arrhythmogenicity are only incompletely understood. This is primarily because of the lack of appropriate experimental models. In most of the studies performed thus far, TEA was used in anesthetized animals. Baseline anesthesia...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200107000-00023
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Although transesophageal echocardiography allows continuous intraoperative cardiac monitoring, the technique has been limited by the lack of a method for realtime, quantitative assessment of cardiac chamber size and systolic function. Automated border detection (ABD), based on an analysis of integrated backs...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199508000-00008
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:The mechanisms of ventilator-induced lung injury, an iatrogenic inflammatory condition induced by mechanical ventilation, are not completely understood. Toll-like receptor 4 (TLR4) signaling via the adaptor protein myeloid differentiation factor 88 (MyD88) is proinflammatory and plays a critical role in host...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181e89ab2
更新日期:2010-09-01 00:00:00
abstract::The hepatic effects of repeated anesthesia of phenobarbital-induced Fischer 344 rats with 1% halothane/14% oxygen were investigated, after anesthetics were administered at either 1-day or 5-day intervals. Urinary excretion of fluoride, a product of reductive halothane metabolism, was increased in the 24-h period follo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198709000-00013
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Recent evidence implicates nitric oxide (*NO) in the pathogenesis of preeclampsia. The authors tested the hypothesis that administration of low-dose endotoxin to pregnant rats mimics the signs of preeclampsia in humans and that *NO and *NO-derived species play a role in that animal model. METHODS:Endotoxin ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200012000-00017
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Cisatracurium, one of the ten isomers in atracurium, is a nondepolarizing muscle relaxant with an intermediate duration of action. It is more potent and less likely to release histamine than atracurium. As one of the isomers composing atracurium, it presumably undergoes Hofmann elimination. This study was co...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199602000-00007
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Blood conservation techniques are being increasingly used because of the increased cost and lack of availability of allogeneic blood. Cell salvage offers great blood savings opportunities but is thought to be contraindicated in a number of areas (e.g., blood contaminated with bacteria). Several outcome studi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200309000-00021
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Macrophage recruitment into atherosclerotic plaques drives lesion progression, destabilization, and rupture. Chronic statin treatment reduces macrophage plaque content. Information on dynamics of macrophage recruitment would help assessing plaque vulnerability and guiding therapy. Techniques to image macroph...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318291c18b
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Obesity is an important risk factor for surgical site infections. The incidence of surgical wound infections is directly related to tissue perfusion and oxygenation. Fat tissue mass expands without a concomitant increase in blood flow per cell, which might result in a relative hypoperfusion with decreased ti...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200402000-00015
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The Bispectral Index (BIS) and the Patient State Index (PSI) quantify depth of anesthesia by analyzing the electroencephalogram. The authors examined the response of BIS and PSI to sevoflurane anesthesia. METHODS:In 22 patients, sevoflurane anesthesia was induced by inhalation with a tight-fitting facemask ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181895fd0
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown. METHODS:To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases volun...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200610000-00007
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Because tactile evaluation is the most common form of clinical neuromuscular monitoring, this study examines the relative efficacy of antagonizing residual block at different levels of recovery of the tactile train-of-four (TOF) response. METHODS:Anesthesia was induced in 64 adults with 2-5 microg/kg fentan...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200201000-00013
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the effic...
journal_title:Anesthesiology
pub_type: 杂志文章,meta分析
doi:10.1097/ALN.0000000000001607
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Procedure times are important variables that often are included in studies of quality and efficiency. However, due to the need for costly chart review, most studies are limited to single-institution analyses. In this article, the authors describe how well the anesthesia claim from Medicare can estimate chart...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200702000-00024
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:While persistent opioid use after surgery has been the subject of a large number of studies, it is unknown how much variability in the definition of persistent use impacts the reported incidence across studies. The objective was to evaluate the incidence of persistent use estimated with different definitions...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003265
更新日期:2020-06-01 00:00:00
abstract::The effect of chronic renal failure (RF) on the pharmacokinetics of morphine was studied in nine patients with end-stage RF, aged 58 +/- 8 yr (SD), and in seven control patients, aged 58 +/- 15 yr, undergoing peripheral surgery under general anesthesia. All patients received 0.2 mg X kg-1 as an intravenous bolus injec...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198703000-00011
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:We have previously shown that intralipid (lipid emulsion) protects the heart against ischemia/reperfusion injury and bupivacaine-induced cardiotoxicity. However, the precise underlying mechanisms are not fully understood. Here we explored the hypothesis that free fatty acid receptor-1 or G-protein-coupled re...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002195
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000809
更新日期:2015-10-01 00:00:00
abstract::Analgesia is an important component of general anesthesia. alpha 2-adrenoceptor agonists such as clonidine and dexmedetomidine are effective analgesics at the spinal level, and furthermore, they reduce the volatile anesthetic requirement. In order to probe a possible spinal-level contribution to general anesthetic-ind...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199109000-00017
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Recent studies have revealed that N2O exerts its antinociceptive effect by inducing opioid peptide release in the brain stem, thereby activating the descending noradrenergic inhibitory neurons, which modulate pain processing in the spinal cord. However, the precise neuronal pathways that mediate these events...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200310000-00030
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Uptake of a second gas of a delivered gas mixture decreases the amount of carrier gas and potent inhaled anesthetic leaving the circle system through the pop-off valve. The authors hypothesized that the vaporizer settings required to maintain constant end-expired sevoflurane concentration (Etsevo) during min...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200208000-00017
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Mild hypothermia is accompanied by metabolic changes. Epidural local anesthetic agents attenuate the surgical stress response, but it is not known whether they modulate thermal stress. METHODS:Thirty patients undergoing colorectal surgery, performed by one surgical team, received epidural 0.5% bupivacaine t...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199805000-00011
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Neuropathic pain is a condition resulting from injury to the peripheral and/or central nervous system. Despite extensive research over the last several decades, neuropathic pain remains difficult to manage. METHODS:The authors conducted a randomized, placebo-controlled, double-blinded, and crossover clinica...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000000693
更新日期:2015-07-01 00:00:00