Comparison of the Effect-Site Keos of Propofol for Blood Pressure and EEG Bispectral Index in Elderly and Younger Patients

2000 ◽  
Vol 44 (3) ◽  
pp. 147
Author(s):  
TOMIEI KAZAMA ◽  
KAZUYUKI IKEDA ◽  
KOJI MORITA ◽  
MUTSUHITO KIKURA ◽  
MATSUYUKI DOI ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bispectral Index ◽  
Younger Patients ◽  
Effect Site

Comparison of the Effect-site keOs of Propofol for Blood Pressure and EEG Bispectral Index in Elderly and Younger Patients

1999 ◽  
Vol 90 (6) ◽  
pp. 1517-1527. ◽  
Author(s):  
Tomiei Kazama ◽  
Kazuyuki Ikeda ◽  
Koji Morita ◽  
Mutsuhito Kikura ◽  
Matsuyuki Doi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Concentration ◽  
Bispectral Index ◽  
Time Course ◽  
Drug Infusion ◽  
Time Data ◽  
Aged Patients ◽  
Younger Patients ◽  
Spectral Edge Frequency ◽  
Effect Site

Background Drug effect lags behind the blood concentration. The goal of this investigation was to determine the time course of plasma concentration and the effects of propofol demonstrated by electroencephalogram or blood pressure changes and to compare them between elderly and young or middle-aged patients. Methods A target-controlled infusion was used to rapidly attain and maintain four sequentially increasing, randomly selected plasma propofol concentrations from 1 to 12 microg/ml in 41 patients aged 20-85 yr. The target concentration was maintained for about 30 min. Bispectral index (BIS), spectral edge frequency, and systolic blood pressure (SBP) were used as measures of propofol effect. Because the time courses of these measures following the started drug infusion showed an exponential pattern, the first-order rate constant for equilibration of the effect site with the plasma concentration (k(eO)) was estimated by fitting a monoexponential model to the effect versus time data resulting from the pseudo-steady-state propofol plasma concentration profile. Results The half-times for the plasma-effect-site equilibration for BIS were 2.31, 2.30, 2.29, and 2.37 min in patients aged 20-39, 40-59, 60-69, and 70-85 yr, respectively (n = 10 or 11 each). The half-times for SBP were 5.68, 5.92, 8.87, and 10.22 min in the respective age groups. All were significantly longer than for BIS (P < 0.05). The propofol concentration at half of the maximal decrease of SBP was significantly greater (P < 0.05) in the elderly than in the younger patients. Conclusions The effect of propofol on BIS occurs more rapidly than its effect on SBP. Age has no effect on the rate of BIS reduction with increasing propofol concentration, whereas with increasing age, SBP decreases to a greater degree but more slowly.

The U-shaped association between achieved blood pressure and risk of cardiovascular events and mortality in elderly and younger patients

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nam-Kyoo Lim ◽  
Hyun-Young Park ◽  
Won-Ho Kim ◽  
Giuseppe Mancia ◽  
Myeong-Chan Cho
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Younger Patients

A-Line, Bispectral Index, and Estimated Effect-Site Concentrations: A Prediction of Clinical End-Points of Anesthesia

2006 ◽  
Vol 102 (4) ◽  
pp. 1141-1146 ◽  
Author(s):  
Sascha Kreuer ◽  
J??rgen Bruhn ◽  
Reinhard Larsen ◽  
Heiko Buchinger ◽  
Wolfram Wilhelm
Keyword(s):  
Bispectral Index ◽  
End Points ◽  
Effect Site

Recovery of Consciousness after Thiopental or Propofol

1997 ◽  
Vol 86 (3) ◽  
pp. 613-619 ◽  
Author(s):  
R. Flaishon ◽  
A. Windsor ◽  
J. Sigl ◽  
P. S. Sebel
Keyword(s):  
Blood Pressure ◽  
Bispectral Index ◽  
Single Injection ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agent ◽  
Surgical Patients ◽  
Loss Of Consciousness ◽  
Induction Dose ◽  
Recovery Of Consciousness

Background Currently, there exists no effective monitor that can predict the probability of a patient being conscious during general anesthesia. The electroencephalogram-derived bispectral index (BIS) is a promising new method to assess anesthetic adequacy. This study used the BIS to predict the probability of recovery of consciousness after a single bolus induction dose of propofol or thiopental. Methods Twenty unpremedicated surgical patients were anesthetized with 4 mg/kg thiopental and 20 patients with 2 mg/kg propofol. The BIS was monitored throughout the study. After induction, before administration of neuromuscular blocking agent, a tourniquet was applied to one arm and inflated above the systolic blood pressure. This allowed preservation of the ability to move the hand after neuromuscular blocking agent onset. Patients were then prompted to squeeze the investigator's hand every 30 s, until they responded to the request. At the time of response, anesthesia was reinduced and the study terminated. Results The BIS at loss of consciousness and recovery of a response was not statistically different between propofol and thiopental. No patient with a BIS less than 58 was conscious. In both groups, a BIS of less than 65 signified a less than 5% probability of return of consciousness within 50 s. Conclusion The BIS can be used to predict probability of recovery of consciousness after a single injection of either thiopental or propofol.

The pharmacodynamics of dexmedetomidine in elderly cardiac patients undergoing analgosedation in the ICU

2018 ◽  
Vol 86 (4) ◽  
pp. 265
Author(s):  
Justyna Alicja Ber ◽  
Mirosław Malec ◽  
Agnieszka Bienert ◽  
Małgorzata Nowicka ◽  
Łukasz Żurański ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Single Dose ◽  
Cardiac Index ◽  
Mean Arterial Blood Pressure ◽  
Bispectral Index ◽  
Cardiac Patients ◽  
Health Conditions ◽  
Arterial Blood ◽  
Dexmedetomidine Infusion

Aim. This study aimed to evaluate the pharmacodynamics of dexmedetomidine in elderly cardiac patients.Material and Methods. Twelve patients of 60 years or older and need for analgesia after surgery or as a result of critical health conditions were included into our study. Dexmedetomidine was administered intravenously as a continuous infusion without the initial dose. At the beginning the infusion was started at the rate of 0.7 μg/kg/h and then it was continued in the range of 0.17–1.39 μg/kg/h according to desired level of sedation. Information about heart rate, systolic, diastolic and mean arterial blood pressure, bispectral index and cardiac index were collected a few minutes before, during and in 12 hours after infusion of dexmedetomidine.Results. The hemodynamic data as well as BIS level were collected from 12 patients. The duration of dexmedetomidine infusion was less than 9 hours. For each patient the reduction in blood pressure and heart rate compared to the value before dexmedetomidine infusion was observed. We did not observe bradycardia in any patient. Appropriate sedation level was achieved using only dexmedetomidine and ranged from 60 to 80. In only 2 cases it was necessary to give a single dose of another sedative.Conclusions. To conclude, in the patients’ population involved in the study, which included older cardiac patients dexmedetomidne has been shown as a sedative agent which enabled to achieve desire level of sedation in the recommended ranges without episodes of bradycardia, however hypotension events were noted.

scholarly journals Relationship between bispectral index and effect-site EC 50 for propofol

2006 ◽  
Vol 96 (2) ◽  
pp. 267-268
Author(s):  
T.A. Lim ◽  
K.Y. Lim ◽  
W.H. Wong
Keyword(s):  
Bispectral Index ◽  
Effect Site

Performance of the ARX-derived Auditory Evoked Potential Index as an Indicator of Anesthetic Depth

2002 ◽  
Vol 96 (4) ◽  
pp. 803-816 ◽  
Author(s):  
Michel M. R. F. Struys ◽  
Erik Weber Jensen ◽  
Warren Smith ◽  
N. Ty Smith ◽  
Ira Rampil ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Evoked Potential ◽  
Auditory Evoked Potential ◽  
Noxious Stimulus ◽  
Gynecologic Surgery ◽  
Effect Compartment ◽  
Loss Of Consciousness ◽  
Anesthetic Depth ◽  
Effect Site ◽  
Effect Site Concentration

Background Autoregressive modeling with exogenous input of middle-latency auditory evoked potential (A-Line autoregressive index [AAI]) has been proposed for monitoring anesthetic depth. The aim of the current study was to compare the accuracy of this new index with the Bispectral Index (BIS), predicted effect-site concentration of propofol, and hemodynamic measures. Methods Twenty female patients scheduled for ambulatory gynecologic surgery received effect compartment controlled infusion of propofol. Target effect-site concentration was started at 1.5 microg/ml and increased every 4 min by 0.5 microg/ml. At every step, sedation level was compared with monitoring values using different clinical scoring systems and reaction to noxious stimulus. Results Bispectral Index, AAI, and predicted propofol effect-site concentration were accurate indicators for the level of sedation and loss of consciousness. Hemodynamic variables were poor indicators of the hypnotic-anesthetic status of the patient. BIS correlated best with propofol effect-site concentration, followed by AAI. Hemodynamic measurements did not correlate well. No indicators predicted reaction to noxious stimulus. Poststimulus, BIS and AAI showed an increase as a result of arousal. This reaction occurred more rapidly with the AAI than with BIS. Conclusion Bispectral Index, AAI, and predicted propofol effect-site concentration revealed information on the level of sedation and loss of consciousness but did not predict response to noxious stimulus.

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