Remifentanil Pharmacokinetics in Obese Versus Lean Patients

Egan, Talmadge D.; Huizinga, Bernou; Gupta, Samir K.; Jaarsma, Rudy L.; Sperry, Richard J.; Yee, James B.; Muir, Keith T.

doi:10.1097/00132586-199906000-00039

Cited by 21 publications

(21 citation statements)

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“…SHINJU OBARA 1) , ISSEI MORIMOTO 2) , YUZO ISEKI 2) , RIEKO OISHI 2) , MIDORI MOGAMI 2) , TSUYOSHI IMAIZUMI 3) , ATSUSHI HOSONO 3) , TAKAHIRO HAKOZAKI 4) , YUKO NAKANO 5) , TSUYOSHI ISOSU 6) and MASAHIRO MURAKAWA …”

Section: [Original Article] the Effect Of Obesity On Dose Of Dexmedetunclassified

The Effect of Obesity on Dose of Dexmedetomidine When Administered With Fentanyl During Postoperative Mechanical Ventilation - Retrospective

Obara

Morimoto

Iseki

et al. 2015

FJMS

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: We carried out a retrospective investigation on the effect of obesity on dexmedetomidine (DEX) requirements when administered with fentanyl (FEN) during mechanical ventilation after major surgeries. After Institutional Review Board approval, 14 obese patients with a body mass index (BMI) ≥ 30 kg/m 2 and the same number of non -obese patients with similar backgrounds to the obese patients were selected from medical records. Doses of DEX in the first 48 h or until the end of sedation or extubation were calculated for comparison. In addition to comparison of dosing between the groups, associations between total body weight (TBW), BMI, and lean body mass (LBM) values and doses of DEX (mcg/h), between BMI and various indices (i.e., amount per TBW per hour and amount per LBM per hour) of DEX doses, and between above indices of DEX and FEN doses were also examined. There were no significant differences in DEX dose indices between the groups. However, DEX requirements (mcg/h) were significantly increased with TBW (kg) (r = 0.51, P = 0.003), BMI (r = 0.49, P = 0.006) and LBM (kg) (r = 0.42, P = 0.02), which might have enhanced the DEX metabolism with physiological changes with obesity. These findings will be beneficial for future clinical pharmacological analysis of DEX.

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Section: [Original Article] the Effect Of Obesity On Dose Of Dexmedetunclassified

The Effect of Obesity on Dose of Dexmedetomidine When Administered With Fentanyl During Postoperative Mechanical Ventilation - Retrospective

Obara

Morimoto

Iseki

et al. 2015

FJMS

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show abstract

“…The pharmacokinetic parameters of remifentanil are more closely related to lean body mass than to total body weight [20]. Because we excluded obese patients (body mass index ＞ 30 kg/m 2 ) from the study, calculation of doses by lean body mass seems to be imperatively necessary.…”

Section: Discussionmentioning

confidence: 99%

Optimal dose of remifentanil for the prevention of hemodynamic responses during induction of anesthesia with desflurane

Hj¹,

Park²,

Baek³

et al. 2015

Anesth Pain Med

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“…11 Egan et al 12 showed that remifentanil pharmacokinetics in obese and non-obese showed significantly higher doses of remifentanil in obese patients if doses were calculated based on actual body weight. This study showed that if compartmental volumes and clearances are adjusted for LBM, then the pharmacokinetics among obese and non-obese are similar, thus confirming that remifentanil dose regimens should be based on ideal body weight or LBM.…”

Section: Pharmoacokinetic Modelsmentioning

confidence: 99%

Review of pharmacokinetic models for target controlled infusions in anesthesia

Sivasubramaniam

2014

Int J Basic Clin Pharmacol

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Remifentanil Pharmacokinetics in Obese Versus Lean Patients

Cited by 21 publications

References 0 publications

The Effect of Obesity on Dose of Dexmedetomidine When Administered With Fentanyl During Postoperative Mechanical Ventilation - Retrospective

The Effect of Obesity on Dose of Dexmedetomidine When Administered With Fentanyl During Postoperative Mechanical Ventilation - Retrospective

Optimal dose of remifentanil for the prevention of hemodynamic responses during induction of anesthesia with desflurane

Review of pharmacokinetic models for target controlled infusions in anesthesia

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