Algesia With Subhypnotic Doses of Thiopentone and Propofol

Wilder‐Smith, O. H. G.; Borgeat, A.

doi:10.1093/bja/67.2.226

Cited by 16 publications

(3 citation statements)

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“…Some studies also suggest that subhypnotic doses of propofol reduce sensitivity to pain. 10,19,20 Therefore, it is possible that propofol reduced pain by itself, apart from its synergistic analgesic effects…”

Section: Resultsmentioning

confidence: 99%

Sedation with alfentanil and propofol for rhizotomies

Rensburg¹,

Conradie

2014

Southern African Journal of Anaesthesia and Analgesia

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Background: Patient safety during sedation for closed rhizotomies is improved when analgesia is optimised, rather than relying on deep sedation for patient comfort. This retrospective study determined the appropriate effect-site concentration (Ce) for alfentanil, in combination with a constant propofol infusion, for optimal pain control during sedation for closed rhizotomies. Airway maintenance is ensured by keeping patients responsive to verbal commands, albeit at the price of inevitable ventilatory depression. Method: The records of patients who received rhizotomies over a six-month period were studied retrospectively. Sixty-three outpatients were included. Patients rated the level of analgesia with each needle placement. If the Ce for alfentanil was adequate, it was kept constant. Otherwise, it was increased in 5 ng/ml increments with each needle placement until analgesia was effective, or up to the maximum Ce for alfentanil of 100 ng/ml. Propofol infusion at a constant Ce of 200 ng/ml was added. Results: Forty-eight per cent of patients reported being comfortable at a Ce for alfentanil of 70-75 ng/ml. Only 5% of patients requested the maximum Ce for alfentanil of 100 ng/ml. All of the patients experienced ventilatory depression, but a patent airway was maintained. The haemodynamic observations were within normal limits. According to the ward records, 16% of the patients complained of nausea, and there was one incident of vomiting. Conclusion: Combining alfentanil at a Ce for alfentanil of 70-100 ng/ml with propofol at 200 ng/ml is a safe and effective method for analgesia during sedation for closed rhizotomies.

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Section: Resultsmentioning

confidence: 99%

Sedation with alfentanil and propofol for rhizotomies

Rensburg¹,

Conradie

2014

Southern African Journal of Anaesthesia and Analgesia

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“…Note: Even though some studies suggest that propofol may have analgesic properties, 13 these are not potent enough to manage the intense pain of many painful procedures. Appropriate analgesic agents should be added for optimal effect.…”

Section: Patients' Emotional Statementioning

confidence: 99%

Sedation for cases without local anaesthetic

Rensburg

2012

Southern African Journal of Anaesthesia and Analgesia

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“…Propofol (2,6‐diisopropylphenol) is one of the most widely used intravenous anaesthetics for the induction and maintenance of general anaesthesia. In addition to its anaesthetic properties, several studies have shown that propofol has antinociceptive effects, including against visceral pain evoked by acetic acid, as well as the capacity to reduce inflammatory pain and depress nociceptive transmission at the spinal level . However, the molecular mechanisms responsible for these antinociceptive effects of propofol remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of acid‐sensing ion channel currents by propofol in rat dorsal root ganglion neurons

Lei

Li²,

Wang

et al. 2014

Clin Exp Pharma Physio

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Acid-sensing ion channels (ASICs), part of the epithelial sodium channel/degenerin family, are activated by extracellular protons. The ASICs play a significant role in the acidosis-mediated perception of pain. The anaesthetic agent propofol also exerts antinociceptive effects, but the underlying mechanisms for this effect are not clear. We used whole-cell patch clamping to investigate the effect of propofol on proton-gated currents in: (i) rat dorsal root ganglion (DRG) neurons; and (ii) HEK293 cells transfected with either ASIC1a or ASIC3. Propofol inhibited the amplitude of proton-gated currents in DRG neurons, but did not change the sensitivity of ASICs to H(+). Notably, propofol altered acid-evoked excitability of rat DRG neurons and decreased the number of action potentials induced by acid stimuli. In addition, we demonstrated that propofol inhibited ASICs by directly binding with these channels in HEK293 cells. These results suggest that propofol inhibits proton-gated currents in DRG neurons and that inhibition of proton-gated currents explains, in part, the antinociceptive effects of propofol in primary afferent neurons.

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Algesia With Subhypnotic Doses of Thiopentone and Propofol

Cited by 16 publications

References 0 publications

Sedation with alfentanil and propofol for rhizotomies

Sedation with alfentanil and propofol for rhizotomies

Sedation for cases without local anaesthetic

Inhibition of acid‐sensing ion channel currents by propofol in rat dorsal root ganglion neurons

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