Relation between fentanyl dose and predicted EC 50 of propofol for laryngeal mask insertion

Kodaka, Mitsuharu; Okamoto, Yukinori; Handa, F; Kawasaki, Jun; Miyao, Hideki

doi:10.1093/bja/aeh033

Cited by 41 publications

(36 citation statements)

References 13 publications

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“…Furthermore, Kodaka et al [16] reported that fentanyl pretreatment reduced the 50% effective concentration of propofol for cLMA insertion, but propofol requirements did not differ whether 1 or 2 lg.kg )1 of fentanyl was given. Goyagi et al [17] have also shown the effect of fentanyl on propofol requirement for cLMA insertion, where fentanyl 2 lg.kg )1 reduced the propofol requirement by 60%, but at the expense of prolonged respiratory depression. These studies are in concordance with our findings.…”

Section: Discussionmentioning

confidence: 94%

Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*

et al. 2007

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SummaryProbit analysis was used to predict an optimal dose of fentanyl, co-administered with propofol 2.5 mg.kg , when inserting the laryngeal mask airway. In all, 21 male and 54 female healthy Chinese patients, aged 18-63 years, requiring anaesthesia for minor surgery were recruited. They were assigned to one of five groups: placebo, 0.5, 1.0, 1.5 and 2.0 lg.kg )1 . Insertion was performed 90 s after administration and insertion conditions assessed using a six-category score. Dose-response curves could only be drawn for swallowing and movement categories, and only the ED 50 could be predicted with certainty. To provide optimal conditions in over 95% of patients, fentanyl doses well above the clinical range were required. A standard fentanyl dose of 1 lg.kg )1 , co-administered with propofol 2.5 mg.kg )1 , provided optimal conditions in 65% of cases. Ninety seconds may have been insufficient time for fentanyl to reach its peak effect.

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Section: Discussionmentioning

confidence: 94%

Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*

et al. 2007

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“…The properties of rapid onset and offset of action and of smooth recovery (6) make propofol an appealing agent alone or in combination with an opioid for procedural sedation (7)(8)(9)(10). However, dose-dependent respiratory depression and hypoxemia are possible, owing to interactions and synergism between sedatives and opioids (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: A randomized study

Yuan

Yang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate the effect of a combination of dexmedetomidine and fentanyl on peripheral oxygen saturation (SpO 2 ) and hemodynamic stability in patients undergoing flexible bronchoscopy. One hundred patients undergoing elective flexible bronchoscopy were randomized into either a propofol-fentanyl group (PF group; n=50) or a dexmedetomidine-fentanyl group (DF group; n=50). SpO 2 values, heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), patients' cough scores and discomfort scores as determined by patients and bronchoscopists, levels of sedation, number of times that additional lidocaine was required, elapsed time until recovery, and adverse events were recorded. The mean SpO 2 values in the DF group were significantly higher than those in the PF group (P<0.01), and HR, SBP and DBP were significantly lower in the DF group than in the PF group (P<0.05). There were no statistically significant differences between the two groups in terms of cough scores or discomfort scores, sedation levels, or number of times that additional lidocaine was required (P>0.05). Elapsed time until recovery in the DF group was significantly longer than in the PF group (P=0.002). The incidence of hypoxemia was significantly lower in the DF group than in the PF group (P= 0.027), but the incidence of bradycardia was significantly higher in the DF group than in the PF group (P= 0.037). Dexmedetomidine-fentanyl was superior to propofol-fentanyl in providing satisfactory SpO 2 . Furthermore, dexmedetomidine-fentanyl attenuated hemodynamic responses during bronchoscopy and maintained hemodynamic stability in the early stage of the procedure. IntroductionFlexible bronchoscopy is commonly used for the diagnosis and management of a variety of pulmonary diseases. However, it is an invasive procedure that can induce coughing, pain, dyspnea and other adverse effects (1,2). The use of sedatives not only can increase patients' safety and comfort (3) but also can make it easier for the bronchoscopist to perform the procedure and thus avoid extending its duration (4). In addition to alleviating the physiological response to airway irritation during the procedure (5), the proper sedatives should have a rapid onset and a short duration of action, in addition to allowing rapid recovery.Propofol, a non-opioid and nonbarbiturate sedative hypnotic agent, is frequently used in the induction and maintenance of anesthesia. The properties of rapid onset and offset of action and of smooth recovery (6) make propofol an appealing agent alone or in combination with an opioid for procedural sedation (7-10). However, dose-dependent respiratory depression and hypoxemia are possible, owing to interactions and synergism between sedatives and opioids (11-13).Dexmedetomidine, a highly selective α 2 -adrenoceptor agonist, has an affinity for α 2 -adrenoceptors that is 8-fold greater than that of clonidine (14). In addition to providing sedative and analgesic effects (15), dexmedetomidine can be applied generally duri...

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“…Fentanyl 0.5, 1, and 2 μg·kg −1 combined with propofol decreased the EC 50 of propofol for CLMA insertion [4]. The authors of that study concluded that supplemental 0.5 μg·kg −1 fentanyl was suffi cient to decrease the predicted EC 50 with minimal respiratory depression.…”

Section: Introductionmentioning

confidence: 98%

Low dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion

et al. 2009

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Relation between fentanyl dose and predicted EC 50 of propofol for laryngeal mask insertion

Abstract: A fentanyl dose of 0.5 micro g kg(-1) is sufficient to decrease predicted EC(50LMA) with minimum respiratory depression and without a high BIS value.

Cited by 41 publications

References 13 publications

Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*

Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*

Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: A randomized study

Low dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion

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Relation between fentanyl dose and predicted EC 50 of propofol for laryngeal mask insertion

Abstract: A fentanyl dose of 0.5 micro g kg(-1) is sufficient to decrease predicted EC(50LMA) with minimum respiratory depression and without a high BIS value.

Cited by 41 publications

References 13 publications

Fentanyl dose–response curves when inserting the LMA Classic™ laryngeal mask airway*

Fentanyl dose–response curves when inserting the LMA Classic™ laryngeal mask airway*

Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: A randomized study

Low dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion

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Product

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Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*

Fentanyl dose–response curves when inserting the LMA Classic^™ laryngeal mask airway*