Predictive Accuracy of Target-controlled Propofol and Sufentanil Coinfusion in Long-lasting Surgery

Pandin, Pierre; Cantraine, Francis; Ewalenko, Patricia; Deneu, Stéphane C.; Coussaert, Edouard; D’Hollander, Alain

doi:10.1097/00000542-200009000-00013

Cited by 16 publications

(8 citation statements)

References 18 publications

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“…Both Pandin et al . [25] and Slepchenko et al . [26] have evaluated the accuracy of a sufentanil TCI system using the pharmacokinetic parameter set developed by Gepts et al .…”

Section: Discussionmentioning

confidence: 99%

The optimal effect-site concentration of sufentanil for laryngeal mask insertion during induction with target-controlled propofol infusion at 4.0 μg/mL

Al-Metwalli

2014

Saudi J Anaesth

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Objective:The objective of this study is to determine the optimal effect-site concentration (Ce) of sufentanil for satisfactory insertion of laryngeal mask airway (LMA) when administered with a target-controlled infusion (TCI) of propofol at 4.0 μg/mL.Materials and Methods:A total of 25 adult patients scheduled for minor elective surgery were enrolled in this study. All patients received induction with a combination of propofol and sufentanil TCI. The TCI of sufentanil was started at a target Ce of 0.1 ng/mL. After equilibrium with the plasma concentration, the TCI of propofol was initiated, targeting a preset Ce of 4.0 μg/mL. After the loss of consciousness, LMA was inserted and assessed by an experienced Anesthesiologist. The Ce of sufentanil for the next patient was guided by modified Dixon's up-and-down method using 0.05 ng/mL as a step size. The Ce of sufentanil required for successful LMA insertion in 50% of adults (EC50) was determined by calculating the midpoint concentration of all independent pairs of patients after at least seven crossover points.Results:The optimal Ce (EC50) of sufentanil for LMA insertion during propofol induction using target Ce of 4 μg/mL was 0.16 ng/mL (95% confidence interval [CI] = 0.12-0.20). There was a significant reduction in propofol induced pain score P = 0.0275 and insignificant hemodynamic changes.Conclusion:Ce of sufentanil required for successful LMA insertion in 50% of patients (EC50) using propofol target Ce of 4.0 μg/mL was 0.16 ng/mL (95% CI = 0.12-0.20) with a significant reduction in the propofol induced pain and hemodynamic stability.

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“…Both Pandin et al . [25] and Slepchenko et al . [26] have evaluated the accuracy of a sufentanil TCI system using the pharmacokinetic parameter set developed by Gepts et al .…”

Section: Discussionmentioning

confidence: 99%

The optimal effect-site concentration of sufentanil for laryngeal mask insertion during induction with target-controlled propofol infusion at 4.0 μg/mL

Al-Metwalli

2014

Saudi J Anaesth

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“…22,23 It has been previously been recommended that the range of plasma target concentration of sufentanil should be in the range of 0.2 to 1 ng/mL. 24 Consistent with these results, we found that the hemodynamic values were remarkably reduced when 0.8 or 1.0 ng/mL of sufentanil infusion was administered compared with 0.4 or 0.6 ng/mL (P , 0.05; Fig. 1), revealing 0.8 or 1.0 ng/mL sufentanil can maintain stable hemodynamic changes.…”

Section: Discussionmentioning

confidence: 99%

Effective Target Concentration of Sufentanil Combined With Sevoflurane Anesthesia for Abdominal Surgery: A Dose-Response Study

Wang¹,

Wang

et al. 2017

International Surgery

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This study was designed to investigate the effects of target-controlled infusion (TCI) of sufentanil with sevoflurane anesthesia on hemodynamics and postoperative recovery of abdominal surgery. Target-controlled infusion of opioid analgesics provides efficient drug use, allowing an accurate achievement of the desired analgesia level and fewer overdoseinduced adverse effects. A total of 80 patients receiving abdominal surgery (surgery for gastric cancer or colorectal cancer) were divided into 4 groups to receive anesthesia with sevoflurane accompanied with different doses of sufentanil (0.4, 0.6, 0.8, or 1.0 ng/mL). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, times to recovery of spontaneous respiration, eye opening, extubation, and orientation were recorded. Hemodynamic measurements were compared among groups. Comparison between the 2 groups of subjects was made with one-way analysis of variance (ANOVA), LSD-t test, or v 2 test. Although sufentanil at 0.8 and 1.0 ng/mL maintained stable perioperative hemodynamics, the higher dose was associated with increased incidence of bradycardia following intubation (10/19 cases, 52.6%; P , 0.05). Additionally, no differences were observed in the incidence of hypotension, hypertension, or tachycardia between groups (P. 0.05). Increased dose of sufentanil was associated with delayed postoperative recovery. These results demonstrate that TCI at 0.8 ng/mL sufentanil accompanied with sevoflurane anesthesia is a suitable anesthetic regimen for abdominal surgery.

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“…Several studies reported on the performance of both anesthetics in TCI using several pharmacokinetic models 59,64 . For sufentanil, in adults [60][61][62] and in some types of cardiac surgeries 61,63 , the mean error performance was between 11% and 30%, and for overweight patients, between 18% and 29%. Target-concentrations of sufentanil used more often, in cardiac surgeries, vary between 0.4 and 2 ng.mL -1 65 , while in noncardiac surgeries they varied between 0.15 and 0.6 ng.mL -1 65 .…”

Section: Safety Margins Of a Pharmacokinetic Model For Tci Of Anesthementioning

confidence: 99%

“…Modelos de IAC para sufentanil e remifentanil já estão disponíveis no Brasil. Diversos estudos foram publicados descrevendo os desempenhos dos dois anestésicos em IAC, durante a utilização de vários modelos farmacocinéticos [59][60][61][62][63][64] . Para o sufentanil, em pacientes adultos, 60-62 e alguns em intervenção cirúrgica cardíaca 61,63 , a média da performance de erro situou-se entre 11% e 30% e para pacientes obesos ficou entre 18% e 29% 56,64 .…”

Section: Margens De Segurança De Um Modelo Farmacocinético Para Iac Dunclassified

Anestesia venosa total em regime de infusão alvo-controlada: uma análise evolutiva

Nora

2008

Rev. Bras. Anestesiol.

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The advent of new infusion pumps with pharmacokinetic models of remifentanil, sufentanil and propofol opens a new chapter in TIVA and aligns Brazil with the world tendency in TCI. Those systems will allow TCI of hypnotics and opioids concomitantly. However, the most important conclusion refers to the economy, since drugs used in those pumps will not be restricted to only one drug company, similar to what happened with propofol. Nowadays, TCI devices for the use of propofol and opioids, which accept any pharmaceutical presentation, with the advantage of changing the concentration of the drug in the syringe according to the dilution desired are available.

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Predictive Accuracy of Target-controlled Propofol and Sufentanil Coinfusion in Long-lasting Surgery

Abstract: This prospective study demonstrates the predictive accuracy of the pharmacokinetic model for sufentanil infusion and confirms that for propofol during long-lasting surgery using standardized rules for the management of target controlled infusion and blood loss replacement.

Cited by 16 publications

References 18 publications

The optimal effect-site concentration of sufentanil for laryngeal mask insertion during induction with target-controlled propofol infusion at 4.0 μg/mL

The optimal effect-site concentration of sufentanil for laryngeal mask insertion during induction with target-controlled propofol infusion at 4.0 μg/mL

Effective Target Concentration of Sufentanil Combined With Sevoflurane Anesthesia for Abdominal Surgery: A Dose-Response Study

Anestesia venosa total em regime de infusão alvo-controlada: uma análise evolutiva

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