Different dosing regimens for propofol induction in obese patients

Lam, Fai; Liao, Chien-Chang; Lee, Yi Jui; Wang, Weu; Kuo, Chien Ju; Lin, Chao-Shun

doi:10.1016/j.aat.2013.06.009

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Other studies evaluating propofol for anesthesia induction have suggested alternatives such as lean body weight or corrected body weight as the preferred metric for dosing secondary to the nonlinear relationship that exists in obese patients between ABW and clearance (Additional file 2) [38][39][40][41][42][43][44][45]. One study described a pharmacokinetic model in obesity that replaced ABW with lean body weight and simulated concentrations were higher with ABW-based dosing [43].…”

Section: Sedation Propofolmentioning

confidence: 99%

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Erstad

Barletta

2020

Crit Care

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Practice guidelines provide clear evidence-based recommendations for the use of drug therapy to manage pain, agitation, and delirium associated with critical illness. Dosing recommendations however are often based on strategies used in patients with normal body habitus. Recommendations specific to critically ill patients with extreme obesity are lacking. Nonetheless, clinicians must craft dosing regimens for this population. This paper is intended to help clinicians design initial dosing regimens for medications commonly used in the management of pain, agitation, and delirium in critically ill patients with extreme obesity. A detailed literature search was conducted with an emphasis on obesity, pharmacokinetics, and dosing. Relevant manuscripts were reviewed and strategies for dosing are provided.

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Section: Sedation Propofolmentioning

confidence: 99%

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Erstad

Barletta

2020

Crit Care

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“…Among them propofol has become popular in developed countries, because it provides rapid onset and safe and effective sedation, and is associated with rapid recovery profile [5,7]. However, propofol sedation is associated with dose‐related side effects including airway obstruction and respiratory and cardiovascular suppression [8–10].…”

Section: Introductionmentioning

confidence: 99%

Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

Hsu

Huang

Chuang

et al. 2015

The Kaohsiung J of Med Scie

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Gastrointestinal (GI) endoscopy is the major technique for diagnosis of GI disease and treatment. Various sedation and analgesia regimens such as midazolam, fentanyl, and propofol can be used during GI endoscopy. The purpose of the study was to compare propofol alone and propofol combination with midazolam and fentanyl in moderate sedation for GI endoscopy. One hundred patients undergoing GI endoscopy were enrolled in this study. All patients received a propofol target-controlled infusion (TCI) to maintain sedation during the procedure. Patients were randomly allocated into either Group P (propofol TCI alone) or Group C (combination of propofol TCI plus midazolam and fentanyl). Dermographic data, anesthetic parameters (sedation regimen, blood pressure, heart rate, and oxygen saturation), procedure parameters (procedure time, colonoscopy, or panendoscopy), propofol consumption, and adverse events (hypoxia, hypotension, and bradycardia) were all recorded. Postprocedural records included recovery time, postoperative adverse events (nausea, vomiting, dizziness, recall, and pain) and satisfaction. The average propofol consumption was 251 ± 83 mg in Group P and 159 ± 73 mg in Group C (p < 0.001). The incidence of transient hypotension was higher in Group P (p = 0.009). The recovery time and discharge time were both shorter in Group C (p < 0.001 and p = 0.006 respectively). Overall, postprocedural adverse events were similar in both groups. The postanesthetic satisfaction was comparable in both groups. TCI of propofol combined with midazolam and fentanyl achieved sedation with fewer hypotension episodes and shorter recovery and discharge time than propofol TCI alone in patients undergoing GI endoscopy.

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“…Nowadays, propofol sedation has become popular in developed countries because it provides rapid onset and safe and effective sedation and is associated with a rapid recovery profile . However, propofol sedation is also associated with dose‐related side effects including airway obstruction and respiratory and cardiovascular suppression, although blood pressure drops in this population were minor significant.…”

Section: Discussionmentioning

confidence: 99%

The feasibility of office‐based propofol sedation for dental care in patients with intellectual disability by sedation practitioners

Vaessen

Schouten

Hoeve³

et al. 2016

Special Care in Dentistry

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Different dosing regimens for propofol induction in obese patients

Abstract: When using single bolus propofol, the CBW60 group showed similar BIS values and hemodynamic effects as the TBW group during the intravenous induction of general anesthesia for obese patients.

Cited by 12 publications

References 24 publications

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

The feasibility of office‐based propofol sedation for dental care in patients with intellectual disability by sedation practitioners

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