The Pharmacodynamic Interaction of Propofol and Alfentanil During Lower Abdominal Surgery in Women

Vuyk, Jaap; Lim, Thien Thien; Engbers, Frank H. M.; Burm, A. G. L.; Vletter, A. A.; Bovill, J. G.; Joseph, Michele

doi:10.1097/00132586-199612000-00041

Cited by 28 publications

(28 citation statements)

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“…Pharmacodynamic interactions have been described previously for propofol and alfentanil infusions. Propofol reduces opioid requirements in response to surgical stimuli [6] and alfentanil enhances the haemodynamic effects of propofol [7]. It is possible therefore that there is a strong pharmacodynamic interaction between propofol and remifentanil in terms of respiratory depression.…”

Section: Discussionmentioning

confidence: 99%

Target‐controlled remifentanil in combination with propofol for spontaneously breathing day‐case patients

1999

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SummaryRemifentanil is a new potent opioid with a very short duration of action irrespective of duration of infusion. It may have a role in day-case anaesthesia as part of a balanced total intravenous anaesthetic technique with propofol. We examined the respiratory depressant effects of remifentanil in 20 patients undergoing day-case anaesthesia. The target plasma concentration of remifentanil was varied while maintaining a constant target-controlled infusion of 4.5 mg.ml ¹1 propofol. In only 12 patients was satisfactory spontaneous respiration maintained. In these patients the median remifentanil target concentration was 1.6 ng.ml ¹1 and was achieved with a median infusion rate of 0.05 mg.kg ¹1 .min ¹1 . The range of target concentrations associated with satisfactory spontaneous respiration was wide and varied over a 4.7-fold range from 0.6 to 2.8 ng.ml ¹1 .

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Section: Discussionmentioning

confidence: 99%

Target‐controlled remifentanil in combination with propofol for spontaneously breathing day‐case patients

1999

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“…Vuyk et al recently evaluated the pharmacodynamic interaction of alfentanil and propofol for lower abdominal surgery, and demonstrated that, by increasing the plasma concentration of alfentanil from 50 to 150 ng. ml -t, the effective concentration (ECs0) of propofol for the regaining of consciousness decreased from 3.8 to 0.8 lag-rnl-l. 17 Although the pharmacodynamic interaction between propofol and alfentanil was found to be nonlinear, the different amounts of opioid used in the above studies would have had an important influence on propofol requirements, in addition to the effects of midazolam. It is important to appreciate that, in our study, although the loading dose and infusion scheme of alfentanil was not computer-driven to achieve a specific target concentration, the infusion regimen was carefully standardized in an attempt to minimize the effects of varying opioid concentrations as a potential confounding variable.…”

Section: Midazolam/propofol Co-inductionmentioning

confidence: 97%

Midazolam and awareness with recall during total intravenous anaesthesia

et al. 1996

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Purpose: A double-blind study was undertaken to evaluate the influence of graded doses of midazolam on propofol infusion requirements, recovery characteristics and the quality of recovery, associated with propofol/alfentanil/02 total intravenous anaesthesia (TIVA ).Methods: Ninety ASA Class I and II subjects scheduled for arthroscopic knee surgery were randomly allocated to receive either placebo (Group PLAC), or midazolam doses of 15, respectively

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“…They are therefore often used concomitantly to attenuate the haemodynamic response to intubation. 19 This study illustrates that additional measures should be taken to contain increases in heart rate in patients in whom increases may be detrimental, i.e. ischaemic heart disease.…”

Section: Discussionmentioning

confidence: 87%

Haemodynamic response to laryngoscopy with and without tracheal intubation

Smith

Becker

2008

Southern African Journal of Anaesthesia and Analgesia

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IntroductionTracheal intubation is accompanied by an increased blood pressure and heart rate. The aim of this study was to find the most important source of this haemodynamic response, namely laryngoscopy or intubation. MethodA standard induction technique was used for all patients. Eighty patients were randomly allocated to one of two groups, one group to undergo laryngoscopy followed by intubation (Group I), and the other laryngoscopy only of duration similar to intubation (Group L). Blood pressure and heart rate were recorded in the ward, before induction of anaesthesia and one, two, three, and four minutes after instrumentation. ResultsThe instrumentation times did not differ significantly (p = 0.20). Over time mean arterial pressures were significantly higher in Group I than in Group L (p = 0.038). Over time the ratios of mean blood pressure and heart rate relative to the preoperative heart rate were significantly greater in Group I than in Group L (p < 0.01). ConclusionBlood pressures and heart rates were significantly greater after laryngoscopy followed by intubation than after laryngoscopy of the same duration not followed by intubation. The induction technique, consisting of lignocaine, alfentanil, and propofol, may have attenuated expected increases in blood pressure but not increases in heart rate after intubation.

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The Pharmacodynamic Interaction of Propofol and Alfentanil During Lower Abdominal Surgery in Women

Cited by 28 publications

References 0 publications

Target‐controlled remifentanil in combination with propofol for spontaneously breathing day‐case patients

Target‐controlled remifentanil in combination with propofol for spontaneously breathing day‐case patients

Midazolam and awareness with recall during total intravenous anaesthesia

Haemodynamic response to laryngoscopy with and without tracheal intubation

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