Retrospective comparison of Eleveld, Marsh, and Schnider propofol pharmacokinetic models in 50 patients

Hüppe, Tobias; Maurer, Felix; Sessler, Daniel I.; Volk, Thomas; Kreuer, Sascha

doi:10.1016/j.bja.2019.10.019

Cited by 18 publications

(11 citation statements)

References 6 publications

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“…Bias (MdPE) <20% was observed in children, adults, and obese adults, but a greater bias (À27%) was observed in older subjects. Our results are similar to those found by Hü ppe and colleagues 5 in adults (bias À18%; precision 22%). Yi and colleagues 6 prospectively validated the propofol PK model from Park and colleagues 24 in underweight Korean patients and also evaluated the Eleveld PK-PD model and found similar results (bias À18.6%; precision 23.1%).…”

Section: Discussionsupporting

confidence: 92%

Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

Vellinga

Hannivoort

Introna

et al. 2021

British Journal of Anaesthesia

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Section: Discussionsupporting

confidence: 92%

Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

Vellinga

Hannivoort

Introna

et al. 2021

British Journal of Anaesthesia

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“… 1 , 2 The target-controlled infusion (TCI) of propofol has been widely studied and applied in clinical settings. 3 , 4 However, the patients’ responses to propofol vary significantly, even under the same target concentration. It had been shown that the time to loss of verbal contact and the time to bispectral index <70 varied by 6.6- and 4.3-fold, respectively.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Gene Variations of GABRA2, GABRB1, GABRG2, GAD1 and SLC1A3 on Patients with Propofol During Anesthesia Induction

Zhang¹,

Zheng²,

Ma³

et al. 2021

PGPM

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Purpose Propofol is one of the most commonly used intravenous sedatives in general anesthesia, while the individual variations of propofol are apparent. The objective of this study was to investigate the influence of genetic variations in GABAergic neurons and glutamatergic neurons on time to loss of consciousness (LOC) and the incidence of hypotension during anesthesia induction. Patients and Methods A total of 140 Chinese patients undergoing thyroid surgery or breast surgery were recruited. Genotyping of candidate genes was carried out using the Agena Bioscience MassARRAY system. Anesthesia induction was initiated with a propofol target plasma concentration (Cp) of 4.0 μg mL −1 . The LOC latency, systolic blood pressure, diastolic blood pressure, mean arterial pressure were documented. Results We found that GABRA2 rs35496835, GABRB1 rs1372496, GABRG2 rs11135176, GABRG2 rs209358, GAD1 rs3791878, SLC1A3 rs1049522 and gender were significant determinants of the patient’s LOC latency following propofol administration. GABRA2 rs11503014 was highly correlated with blood pressure reduction during anesthesia induction. Multiple linear regression analysis revealed that GABRB1 rs1372496, GABRG2 rs11135176, and SLC1A3 rs1049522 accounted for 35.3% variations in LOC latency following propofol administration. Conclusion Our findings indicate that genetic variants of GABRA2, GABRB1, GABRG2, GAD1 and SLC1A3 may have influence on propofol susceptibility, which would be an important guidance towards building clinical models that can precisely predict the efficacy of propofol with various populations before surgery.

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“…This error cannot be reduced below 20% even by adding further covariates in larger patient collectives. 20…”

Section: Resultsmentioning

confidence: 99%

Quantification of exhaled propofol is not feasible during single‐lung ventilation using double‐lumen tubes: A multicenter prospective observational trial

Hüppe

Kreuer

Wulf

et al. 2023

Acta Anaesthesiol Scand

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Background Volatile propofol can be measured in exhaled air and correlates to plasma concentrations with a time delay. However, the effect of single‐lung ventilation on exhaled propofol is unclear. Therefore, our goal was to evaluate exhaled propofol concentrations during single‐lung compared to double‐lung ventilation using double‐lumen tubes. Methods In a first step, we quantified adhesion of volatile propofol to the inner surface of double‐lumen tubes during double‐ and single‐lumen ventilation in vitro. In a second step, we enrolled 30 patients scheduled for lung surgery in two study centers. Anesthesia was provided with propofol and remifentanil. We utilized left‐sided double‐lumen tubes to separately ventilate each lung. Exhaled propofol concentrations were measured at 1‐min intervals and plasma for propofol analyses was sampled every 20 min. To eliminate the influence of dosing on volatile propofol concentration, exhalation rate was normalized to plasma concentration. Results In‐vitro ventilation of double‐lumen tubes resulted in increasing propofol concentrations at the distal end of the tube over time. In vitro clamping the bronchial lumen led to an even more pronounced increase (Δ AUC +62%) in propofol gas concentration over time. Normalized propofol exhalation during lung surgery was 31% higher during single‐lung compared to double‐lung ventilation. Conclusion During single‐lung ventilation, propofol concentration in exhaled air, in contrast to our expectations, increased by approximately one third. However, this observation might not be affected by change in perfusion‐ventilation during single‐lung ventilation but rather arises from reduced propofol absorption on the inner surface area of the double‐lumen tube. Thus, it is only possible to utilize exhaled propofol concentration to a limited extent during single‐lung ventilation. Registration of Clinical Trial DRKS‐ID DRKS00014788 (http://www.drks.de).

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Retrospective comparison of Eleveld, Marsh, and Schnider propofol pharmacokinetic models in 50 patients

Cited by 18 publications

References 6 publications

Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

The Effects of Gene Variations of GABRA2, GABRB1, GABRG2, GAD1 and SLC1A3 on Patients with Propofol During Anesthesia Induction

Quantification of exhaled propofol is not feasible during single‐lung ventilation using double‐lumen tubes: A multicenter prospective observational trial

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