Ethnic differences in propofol and fentanyl response: a comparison among Caucasians, Kenyan Africans and Brazilians

Ortolani, O; Conti, A. M. Fuhrman; Ngumi, Zipporah W W; Texeira, L.; Olang, P; Amani, I.; Medrado, V. C.

doi:10.1097/00003643-200404000-00011

Cited by 21 publications

(10 citation statements)

References 11 publications

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“…In both studies, ethnicity was a significant predictor of propofol requirement and there is evidence that this factor affects clinical aspects of propofol anaesthesia [15, 16]. While multivariate analysis should account for any ethnic effects, it may be relevant that a third of the patients in Maranets and Kain’s study were Hispanic – a group almost entirely absent from our own study and therefore impossible to include specifically in our analyses.…”

Section: Discussionmentioning

confidence: 90%

The effect of pre‐operative anxiety on induction of anaesthesia with propofol*

et al. 2008

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Summary In this prospective study, we investigated the effects of anxiety on the induction dose of propofol and subsequent cardiovascular changes in 197 patients. Pre‐operative state and trait anxiety scores were measured using the State Trait Anxiety Inventory. Propofol was administered at 40 mg.kg−1.h−1. Propofol dose was recorded at loss of verbal response and when EEG Bispectral Index decreased to 50. Thereafter, propofol infusion rate was reduced to 8 mg.kg−1.h−1. Cardiovascular data were collected for 15 min after starting induction. Maximum percentage decreases in heart rate and mean arterial pressure, and the point at which the latter occurred, were recorded. On multivariate analysis, anxiety scores did not significantly affect propofol dose or cardiovascular end‐points, although Bispectral Index at loss of verbal response decreased with increasing trait anxiety (p = 0.02). Anxiety, measured using State Trait Anxiety Inventory, does not appear independently to affect the induction characteristics of propofol.

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Section: Discussionmentioning

confidence: 90%

The effect of pre‐operative anxiety on induction of anaesthesia with propofol*

et al. 2008

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“…To maintain a similar intraoperative BIS, Malaysian Indians require less propofol than their Chinese or indigenous counterparts, or than Italian Caucasians [3]. Black African patients recover more slowly from propofol anaesthesia than Caucasians [1, 2]. Within the last few years, a study has shown ethnicity to affect the minimum alveolar concentration of sevoflurane [4], a finding discussed in an associated editorial [10].…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade it has been suggested that ethnicity may affect the clinical response to general anaesthetics [1–4], with Caucasian subjects generally shown to be less susceptible to the anaesthetic effects of propofol than other races [1–3]. To date, however, the effect of ethnicity on the induction dose of propofol has not been fully investigated.…”

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confidence: 99%

Effect of ethnicity on the hypnotic and cardiovascular characteristics of propofol induction

et al. 2010

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We compared the propofol dose causing loss of verbal response and suppression of bispectral index to 50, between 50 white and 50 black patients, aged 18-65 years. Propofol was administered at 40 mg.kg )1 .h )1 and reduced to 8 mg.kg.h )1 when bispectral index fell to 50. We recorded heart rate and mean arterial pressure for 15 min in total and calculated, for this period, maximal percentage change from baseline for each. A statistician, blinded to patient ethnicity, found mean (SD) propofol dose for loss of verbal response in white and black patients to be 1.41 (0.37) mg.kg change in heart rate were 14.1 (12.6) % and 7.5 (14.0) % (p = 0.015). Other differences were non-significant. The dose of propofol required for loss of verbal response, but not for suppression of bispectral index to 50, is lower in black than in white patients. In the last decade it has been suggested that ethnicity may affect the clinical response to general anaesthetics [1-4], with Caucasian subjects generally shown to be less susceptible to the anaesthetic effects of propofol than other races [1][2][3]. To date, however, the effect of ethnicity on the induction dose of propofol has not been fully investigated. In our earlier study on anxiety and propofol induction [5], we used multivariate analysis to investigate factors independently predictive of propofol dose requirement for loss of verbal response. In doing so, we established that white ethnicity was associated with greater propofol dose requirement than other ethnic groups.To investigate this incidental finding further, we studied a new group of patients using a study design better suited to address specifically the issue of ethnicity. Our aim was to determine whether the induction dose of propofol differs between British patients describing themselves as white and black. Our null hypothesis was that ethnicity does not affect the dose of propofol required to produce loss of verbal response. We also sought to establish whether the initial cardiovascular characteristics of propofol anaesthesia differ between white and black patients. MethodsWith Research Ethics Committee approval and written informed consent, we recruited 269 patients of ASA physical status 1-2, aged 18-65 years, scheduled for surgery under general anaesthesia. We did not study patients who were of neither white nor black ⁄ black

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“…Physiological conditions, such as age [28] , race [29] , gender [30] , low body temperature [31] , acid-base imbalances [32] , low blood glucose [33] or cerebral ischemia [26] also have a significant effect on patient can influence the EEG. The changes in the patient's age or general health may require adjustment of anesthetic agents.…”

Section: Factors That Interfere Eeg Measurementsmentioning

confidence: 99%

Monitoring for depth of anesthesia: a review

Amornyotin

2012

JBGC

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Monitoring depth of anesthesia is a newer advance in the monitoring of anesthesia. Accurate assessment of the depth of anesthesia contributes to tailoring drug administration to the individual patient. Its increasing use may help to prevent awareness or excessive anesthetic depth and to improve the patients' outcomes. Awareness experiences frighten the patients and can leave a lifetime of residual emotional and psychological problems. To date, no monitoring system has been found to measure the depth of anesthesia reliably for all patients and all anesthetic agents. In this review, the author critically analyzes the use of a number of the depth of anesthesia monitors including the traditional techniques and the modern techniques.

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Ethnic differences in propofol and fentanyl response: a comparison among Caucasians, Kenyan Africans and Brazilians

Cited by 21 publications

References 11 publications

The effect of pre‐operative anxiety on induction of anaesthesia with propofol*

The effect of pre‐operative anxiety on induction of anaesthesia with propofol*

Effect of ethnicity on the hypnotic and cardiovascular characteristics of propofol induction

Monitoring for depth of anesthesia: a review

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