Abstract:
BACKGROUND:The objective of this study was to develop a pharmacokinetic (PK) model to characterize the influence of obesity on propofol PK parameters. METHODS:Nineteen obese ASA II patients undergoing bariatric surgery were studied. Patients received propofol 2 mg kg(-1) bolus dose followed by a 5-20-40-120 min, 10-8-6-5 mg kg(-1) h(-1) infusion. Arterial blood samples were withdrawn at 1, 3, 5 min after induction, every 10-20 min during propofol infusion, and every 10-30 min for 2 h after stopping the propofol infusion. Arterial samples were processed by high-performance liquid chromatography. Time-concentration data profiles from this study were pooled with data from two other propofol PK studies available at http://www.opentci.org. Population PK modelling was performed using non-linear mixed effects model. RESULTS:The study involved 19 obese adults who contributed 163 observations. The pooled analysis involved 51 patients (weight 93 sd 24 kg, range 44-160 kg; age 46 sd 16 yr, range 25-81 yr; BMI 33 sd 9 kg m(-2), range 16-52 kg m(-2)). A three-compartment model was used to investigate propofol PK. An allometric size model using total body weight (TBW) was superior to all other models investigated (linear TBW, free fat mass, lean body weight, normal fat mass) for all clearance parameters. Variability in V2 and Q2 was reduced by a function showing a decrease in both parameters with age. CONCLUSIONS:We have derived a population PK model using obese and non-obese data to characterize propofol PK over a wide range of body weights. An allometric model using TBW as the size descriptor of volumes and clearances was superior to other size descriptors to characterize propofol PK in obese patients.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Cortínez LI,Anderson BJ,Penna A,Olivares L,Muñoz HR,Holford NH,Struys MM,Sepulveda Pdoi
10.1093/bja/aeq195subject
Has Abstractpub_date
2010-10-01 00:00:00pages
448-56issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33471-2journal_volume
105pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The influence of changes in body position relevant to neuraxial blockade on the location of the spinal cord and related neural structures has not been fully quantified. Our aim was to determine the changes, if any, that occur in the location of the spinal cord tip [equivalent to the tip of the conus medullar...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen295
更新日期:2008-12-01 00:00:00
abstract::Two patients are described in whom failure of the Pollard endotracheal tube produced complete respiratory obstruction. Comparisons are made of external diameters, resistance to gas flow and resistance to compression between Pollard tubes and several conventional tubes. It is concluded that the Pollard tube is not sati...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.2.179
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Recent studies have shown that ultrasound guidance for paediatric regional anaesthesia can improve the quality of upper extremity and neuraxial blocks. We therefore investigated whether ultrasound guidance for sciatic and femoral nerve blocks prolongs sensory blockade in comparison with nerve stimulator guid...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem092
更新日期:2007-06-01 00:00:00
abstract::Magnesium inhibits the release of acetylcholine from the motor nerve terminal and thus potentiates the action of the non-depolarizing neuromuscular blocking drugs. We have examined the possibility that this effect might enhance the speed of onset of non-depolarizing block with pancuronium. Following the administration...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/66.2.247
更新日期:1991-02-01 00:00:00
abstract::A 4-year-old girl developed severe hepatitis following the fourth administration of halothane in a period of 5 months. She was shown to have a circulating antibody which acted specifically against rabbit hepatocyte previously sensitized to halothane. The patient made a full recovery from the hepatitis, but 5 months la...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.3.349
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:After cardiac surgery adequate postoperative analgesia is necessary. We assessed analgesia using intrathecal morphine and clonidine. METHODS:In a double-blind randomized study, 45 patients having coronary artery bypass graft surgery were allocated randomly to receive i.v. patient-controlled analgesia (PCA) ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeg070
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Low bispectral index values frequently reflect EEG suppression and have been associated with postoperative mortality. This study investigated whether intraoperative EEG suppression was an independent predictor of 90 day postoperative mortality and explored risk factors for EEG suppression. METHODS:This obse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aeu105
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:In critically ill children, monitoring of cardiac output (CO) is essential to guide haemodynamic management and facilitate cardiovascular therapy. The ultrasound dilution technique (UDT), a novel minimally invasive indicator method, was recently introduced to determine CO. We validated UDT against the 'gold ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet382
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Chronic treatment with renin-angiotensin system (RAS) antagonists frequently causes deleterious hypotension during anaesthesia. We compared the effects of angiotensin II receptor antagonists (ARA) and angiotensin-converting enzyme inhibitors (ACEI) on neurohormonal levels and haemodynamics during cardiopulmo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael268
更新日期:2006-12-01 00:00:00
abstract::The rate of gastric emptying in pregnancy was measured indirectly using the rate of paracetamol absorption in four groups of 15 patients: non-pregnant controls, first trimester patients presenting for termination of pregnancy, second trimester patients presenting for prostaglandin termination of pregnancy, and patient...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.1.54
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:The pharmacokinetic profile of local anaesthetics is influenced by the mode of administration. We sought to compare the pharmacokinetics of two doses of ropivacaine after fascia iliaca compartment (FIC) block in children. METHODS:In this prospective, double-blind study, children received an FIC block as a p...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeh066
更新日期:2004-03-01 00:00:00
abstract::Volatile anaesthetics have been shown to have direct relaxant effects on airway smooth muscle. We have examined the effects of 0.9, 1.9, and 2.8 dog MAC of desflurane and halothane on isolated proximal and distal canine airways precontracted with acetylcholine. The proximal and distal airway smooth muscle relaxed with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.6.841
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:We investigated the effects of total i.v. anaesthesia (TIVA) and balanced anaesthesia (BAL) with sevoflurane on postoperative lung function in patients undergoing surgery in the prone position. METHODS:Sixty patients, aged 21-60 yr, undergoing elective lumbar disc surgery in the prone position were randomly...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq321
更新日期:2011-02-01 00:00:00
abstract::We have conducted a randomized, double-blind comparison of 4% and 8% sevoflurane for induction of anaesthesia in unpremedicated patients aged more than 60 yr. Sevoflurane was inhaled in 50% nitrous oxide using a vital capacity breath technique, and mean, systolic and diastolic arterial pressures and heart rate were mo...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.1.20
更新日期:1999-01-01 00:00:00
abstract::I.V. fluid therapy plays a fundamental role in the management of hospitalized patients. While the correct use of i.v. fluids can be lifesaving, recent literature demonstrates that fluid therapy is not without risks. Indeed, the use of certain types and volumes of fluid can increase the risk of harm, and even death, in...
journal_title:British journal of anaesthesia
pub_type: 共识发展会议,杂志文章,评审
doi:10.1093/bja/aeu300
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:High-frequency oscillation (HFO) is a widely used lung-protective ventilatory strategy in paediatric and neonatal acute lung injury. Its safe and effective use has been hindered by inadequate recruitment of the lung during oscillation and, until recently, the lack of an adequately powered oscillator for use ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.5.708
更新日期:2002-05-01 00:00:00
abstract::Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitate...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.4.363
更新日期:1977-04-01 00:00:00
abstract::Blood loss and the frequency of vomiting were assessed at 88 spontaneous vertex deliveries. An i.v. injection of oxytocin 10 u was as effective as ergometrine 0.5 mg in controlling bleeding from the uterus after delivery. The continuous infusion of a dilute solution of oxytocin in the first stage of labour was not fol...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/51.2.113
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Positive end-expiratory pressure (PEEP) is widely used to improve oxygenation and prevent alveolar collapse in mechanically ventilated patients with the acute respiratory distress syndrome (ARDS). Although PEEP improves arterial oxygenation predictably, high-PEEP strategies have demonstrated equivocal improv...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew314
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:The second gas effect (SGE) is considered to be significant only during periods of large volume N(2)O uptake (VN(2)O); however, the SGE of small VN(2)O has not been studied. We hypothesized that the SGE of N(2)O on sevoflurane would become less pronounced when sevoflurane administration is started 60 min aft...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael008
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:There has been increasing use of invasive techniques, such as extracorporeal organ support, in intensive care units (ICU), and declining autopsy rates. Thus, new measures are needed to maintain high-quality standards. We investigated the potential of computed tomography (CT)-based virtual autopsy to substitu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.02.031
更新日期:2018-06-01 00:00:00
abstract::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 00:00:00
abstract::Muscle fasciculations and pain following the administration of suxamethonium were assessed in a group of patients who performed a series of stretch exercises approximately 1 h before operation. Comparison was made with a group who received suxamethonium but no pretreatment. Fasciculations were significantly reduced in...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.5.596
更新日期:1987-05-01 00:00:00
abstract::The clinical understanding of the dynamics of myocardial contraction is hampered by an over-simplified interpretation of the intramural pattern of force generation. This limits the anaesthetist's knowledge of the direct effects of commonly used anaesthetics. A discrimination between a negative inotropic effect and cha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/60.suppl_1.2s
更新日期:1988-01-01 00:00:00
abstract::We describe the anaesthetic management of a patient undergoing lobectomy for cavitating lung abscess complicated by haemoptysis. Surgery for lung abscess is one of the absolute indications for the use of a double-lumen tube (DLT). Because pus or blood could impede fibreoptic-assisted DLT placement, a traditional, blin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.791
更新日期:2000-11-01 00:00:00
abstract::Seventy-two adult surgical patients were studied to compare neuromuscular and cardiovascular effects of mivacurium chloride during nitrous oxide-fentanyl-thiopentone (BAL group) or nitrous oxide-halothane (HAL group) anaesthesia. Eighteen patients in the BAL group received an initial bolus of mivacurium, either the ED...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/64.2.193
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Desflurane (DES)-induced preconditioning is mediated by large-conductance calcium-activated potassium channels (BK(Ca)). Whether BK(Ca) are involved in anaesthetic-induced post-conditioning is unknown. We tested the hypothesis that DES-induced post-conditioning is mediated by BK(Ca) upstream of the mitochond...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer496
更新日期:2012-04-01 00:00:00
abstract::A simple mathematical model of the chest wall was constructed so that during tidal breathing the relative volume contributions of the rib cage and abdomen/diaphragm could be measured in man, using four mercury-in-rubber strain gauges around the trunk. From the dimensions of the trunk and the change in circumference de...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.5.391
更新日期:1979-05-01 00:00:00
abstract::Intragastric pressure was measured in 20 patients before, and immediately after, the induction of anaesthesia with thiopentone. Intragastric pressure decreased in patients whose weights were the same as or less than expected, and increased in five of seven patients whose weights were greater than expected (P = 0.0013)...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.8.873
更新日期:1984-08-01 00:00:00
abstract::Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/61.2.180
更新日期:1988-08-01 00:00:00