Effect of remifentanil on plasma propofol concentration and bispectral index during propofol anaesthesia

Yufune, Shinya; Takamatsu, Isao; Masui, Kenichi; Kazama, Tomiei

doi:10.1093/bja/aeq334

Cited by 32 publications

(17 citation statements)

References 25 publications

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“…39 In addition, a significant increase in propofol concentrations has also been observed after the administration of remifentanil 1.0 mg kg 21 min 21 in adult patients. 40 Although we used somewhat lower doses of sevoflurane and remifentanil, a possible PK interaction of propofol with these two drugs cannot be ruled out.…”

Section: Discussionmentioning

confidence: 95%

Performance evaluation of paediatric propofol pharmacokinetic models in healthy young children

Sepúlveda

Cortínez

Sáez

et al. 2011

British Journal of Anaesthesia

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Section: Discussionmentioning

confidence: 95%

Performance evaluation of paediatric propofol pharmacokinetic models in healthy young children

Sepúlveda

Cortínez

Sáez

et al. 2011

British Journal of Anaesthesia

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“…13 It is therefore likely that the suppression of propofol-induced body movements observed in the present study with the addition of adjunct agents was due to the analgesic actions of remifentanil and nitrous oxide inducing an increased depth of anesthesia that was not reflected in the BIS values. [14][15][16] Remifentanil is known to decrease heart rate and blood pressure through vagotonic and sympatholytic .0 (17.1) † Hemodynamic parameters during the procedure were significantly lower than the control. Values are mean (SD).…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that in addition to promoting hemodynamic stability by inhibiting noxious stimuli, nitrous oxide also prevented hemodynamic fluctuations by producing an increased depth of anesthesia not reflected in the BIS values. [14][15][16] In the present study, ephedrine hydrochloride did not need to be administered to any of the patients because the severity of hemodynamic depression was not clinically relevant.…”

mentioning

confidence: 97%

Remifentanil in Combination With Propofol Is Suitable for Use in the Dental Outpatient Setting

Maeno

Fukuda

Sakamoto

et al. 2016

Anesthesia Progress

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Although several adjuncts to the general anesthetic propofol have been proposed, there is insufficient research identifying the ideal agent, and in what dosage, to combine with propofol in dental outpatient anesthesia. Here we examined the combination of remifentanil or nitrous oxide and propofol in patients with severe dental avoidance undergoing dental treatment in the outpatient setting. Eighty patients were randomized to 4 groups and administered propofol/saline solution (PS; n ¼ 20), propofol/remifentanil 0.25 lg/kg/min (PRe-0.25; n ¼ 20), propofol/remifentanil 0.125 lg/kg/min (PRe-0.125; n ¼ 20), or propofol/66% nitrous oxide (PN; n ¼ 20). During anesthesia, the bispectral index value was kept between 40 and 60. Body movements and hemodynamic changes during anesthesia, emergence, and recovery as well as anesthetic cost were compared between the combinations. Body movements were observed in all patients administered PS but in no patients administered PRe-0.25, PRe-0.125, or PN. Postoperative nausea was observed in 5 patients (25%) administered PRe-0.25 and in 1 patient (5%) administered PN. Although both PRe-0.125 and PN were useful clinically, PRe-0.125 was the least expensive combination.

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“…An investigation of the effect of remifentanil on plasma propofol concentration has found that remifentanil reduces hepatic clearance of propofol and significantly increases the propofol C p [112].…”

Section: Model Uncertaintymentioning

confidence: 99%

Automation of anaesthesia: a review on multivariable control

Chang

Syafiie

Kamil

et al. 2014

J Clin Monit Comput

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Anaesthesia is a multivariable problem where a combination of drugs are used to induce desired hypnotic, analgesia and immobility states. The automation of anaesthesia may improve the safety and cost-effectiveness of anaesthesia. However, the realization of a safe and reliable multivariable closed-loop control of anaesthesia is yet to be achieved due to a manifold of challenges. In this paper, several significant challenges in automation of anaesthesia are discussed, namely model uncertainty, controlled variables, closed-loop application and dependability. The increasingly reliable measurement device, robust and adaptive controller, and better fault tolerance strategy are paving the way for automation of anaesthesia.

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Effect of remifentanil on plasma propofol concentration and bispectral index during propofol anaesthesia

Abstract: Remifentanil reduced the CI and increased the Cp, which may be related to a decrease in the K-ICG, but had no significant effect on the BIS.

Cited by 32 publications

References 25 publications

Performance evaluation of paediatric propofol pharmacokinetic models in healthy young children

Performance evaluation of paediatric propofol pharmacokinetic models in healthy young children

Remifentanil in Combination With Propofol Is Suitable for Use in the Dental Outpatient Setting

Automation of anaesthesia: a review on multivariable control

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