Gender differences between predicted and measured propofol CP50 for loss of consciousness

Kodaka, Mitsuharu; Suzuki, Tomohiko; Maeyama, Akihiko; Koyama, K.; Miyao, Hideki

doi:10.1016/j.jclinane.2006.08.004

Cited by 28 publications

(20 citation statements)

References 17 publications

(24 reference statements)

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“…Second, Hui et al made a single assessment of LOC two minutes after ketamine administration, while we stimulated patients every 30 seconds until LOC. The effectsite concentration at LOC by propofol alone in the present study was 2.14 μg/mL, which was comparable to previous investigations using Diprifusor [28,29]. Eighty percent of our control group and 32% of our ketamine group experienced propofol injection pain (Table 3).…”

Section: Discussionsupporting

confidence: 89%

Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Okuyama

Inomata

Okubo

et al. 2011

Journal of Clinical Anesthesia

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Section: Discussionsupporting

confidence: 89%

Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Okuyama

Inomata

Okubo

et al. 2011

Journal of Clinical Anesthesia

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“…A number of reports have suggested that the plasma concentration of propofol decreases more rapidly in women than in men, and that women tend to recover faster from propofol anesthesia than men [7][8][9][11][12][13][14][15]. Loryan et al suggested this sex difference was due to the fact that women's livers have 1.9-fold greater CYP2B6 protein levels than men [7].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the pharmacokinetics of propofol, sex has been reported to influence propofol metabolism and the effect of propofol, in addition to age, height, and weight [5][6][7][8][9][10][11][12][13][14][15]: for example, propofol metabolism in women is faster than that in men, and women awake faster than men. For clinical factors, hemodynamic state might also affect the accuracy of the TCI system [16], because the clearance of propofol depends on the hepatic blood flow [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Effect of sex and polymorphisms of CYP2B6 and UGT1A9 on the difference between the target-controlled infusion predicted and measured plasma propofol concentration

et al. 2018

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Introduction: To examine whether sex and polymorphisms of cytochrome P450 (CYP) 2B6 and UDPglucuronosyltransferase (UGT) 1A9 affect the difference between predicted and measured plasma propofol concentration during continuous infusion by target-controlled infusion.Results: Blood samples of 69 patients (48 men and 21 women) were obtained at 4 h after initial propofol infusion. Percentage performance error (PE) was calculated to assess the difference between measured and predicted propofol concentration. Regression coefficients (β) and 95% confidence intervals (CI) of sex and the polymorphisms of CYP2B6 and UGT1A9 for PE were, separately and mutually, estimated with linear regression. Covariates included age and body mass index in the minimal adjusted model, and additionally included clinical factors (mean blood pressure, heart rate, volume of intravenous fluid, surgical site, surgical position, and pneumoperitoneum) in the full adjusted model. PE was higher in men than in women (28.7% versus 10.5%, p = 0.015). Female sex was inversely associated with PE: the minimal adjusted β = − 8.84 (95% CI, − 16.26 to − 1.43); however, the fully adjusted β with clinical factors became not significant. The average of PE did not differ between polymorphisms of CYP2B6 and UGT1A9, and β of CYP2B6 516G>T polymorphisms mutually adjusted with female sex was not significant. Mean blood pressure, heart rate, and volume of intravenous fluid were independently associated with PE in the full adjusted model. Conclusions: Under 4 h anesthesia with propofol target-controlled infusion in our population, sex differences appeared to exist in the propofol concentration, which might be largely mediated by clinical factors, such as hemodynamic status.

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“…Most studies with this approach in anesthesiology study 20-40 patients [21][22][23][24][25][26][27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients

Silva

Matsui

Kim

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.

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Gender differences between predicted and measured propofol CP50 for loss of consciousness

Cited by 28 publications

References 17 publications

Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Pretreatment with small-dose ketamine reduces predicted effect-site concentration of propofol required for loss of consciousness and Laryngeal Mask Airway insertion in women

Effect of sex and polymorphisms of CYP2B6 and UGT1A9 on the difference between the target-controlled infusion predicted and measured plasma propofol concentration

Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients

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