The Pharmacokinetics of Propofol in Children Using Three Different Data Analysis Approaches

Kataria, Bideshwar K.; Ved, Sudha A.; Nicodemus, H. F.; Hoy, Gregory R.; Lea, Dawn; Dubois, Michel Y.; Mandema, Jaap W.; Shafer, Steven L.

doi:10.1097/00000542-199401000-00018

Cited by 297 publications

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“…11 The propofol dosing regimen used in the present study was adapted from published pharmacokinetic studies of propofol infusion data in children. [12][13][14][15] For the "low" propofol concentration arm of the study, a manual infusion regimen capable of maintaining an estimated steady state blood concentration of 3 µg·mL -1 in children was used. 8 This same target concentration has been chosen in several adult studies.…”

Section: Objectifmentioning

confidence: 99%

“…Further evaluation aimed at validating this propofol infusion regimen might be beneficial. Pediatric propofol pharmacokinetic studies carried out by Kataria et al 15 and Short et al 14 have shown that upon discontinuation of a 30-min infusion, serum propofol levels decrease by 50% in well under ten minutes. The propofol dosing adjustment strategy used in the present study was derived in part from findings reported in these pharmacokinetic studies.…”

Section: Objectifmentioning

confidence: 99%

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Propofol decreases cerebral blood flow velocity in anesthetized children

Karsli

Luginbuehl

Farrar

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Propofol, by virtue of its favourable pharmacokinetic profile, is suitable for maintenance of anesthesia by continuous infusion during neurosurgical procedures in adults. It is gaining popularity for use in pediatric patients. To determine the effects of propofol on cerebral blood flow in children, middle cerebral artery blood flow velocity (Vmca) was measured at different levels of propofol administration by transcranial Doppler (TCD) sonography.M Me et th ho od ds s: : Twelve ASA I or II children, aged one to six years undergoing elective urological surgery were randomized to receive one of two propofol dosing regimens. Half of the patients received propofol in an escalating fashion, initially targeting an estimated steady-state serum concentration of 3 µg·mL -1 , which was then doubled. The other half received propofol designed initially to target the high concentration followed by the lower one. In each child anesthesia was induced and maintained with propofol according to the protocol, rocuronium was given to facilitate tracheal intubation, and a caudal epidural block was performed. A TCD probe was placed appropriately to measure Vmca. Cerebral blood flow velocity (CBFV), mean arterial pressure (MAP) and heart rate (HR) were recorded simultaneously at both levels of propofol administration.R Re es su ul lt ts s: : Twelve patients were studied. At the higher estimated target serum propofol concentration there were significant decreases in Vmca (17%, P < 0.001), MAP (6%, P < 0.002) and HR (8%, P < 0.05) when compared to the lower targeted concentration.C Co on nc cl lu us si io on n: : This study shows that a higher rate of propofol infusion is associated with lower CBFV and MAP values in children. Propofol's cerebral vasoconstrictive properties may be responsible for this finding. Vacm (17 %, P < 0,001), de TAM (6 %, P < 0,002) et de FC (8 %, P < 0,05) Objectif Résultats : Des baisses significatives de

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Section: Objectifmentioning

confidence: 99%

Section: Objectifmentioning

confidence: 99%

Propofol decreases cerebral blood flow velocity in anesthetized children

Karsli

Luginbuehl

Farrar

et al. 2002

Can J Anesth/J Can Anesth

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“…Na criança, as curvas de concentrações do propofol são melhor descritas pelo modelo tricompartimental, com uma meia-vida inicial curta (1,5 a 4,2 minutos), pela ocorrência da redistribuição que é seguida por uma segunda fase (9,3 a 56 minutos) associada à alta depuração metabólica no fígado e em outros locais de grande volume de distribuição. Finalmente, a terceira fase final (209 a 475 minutos) reflete o período de eliminação lenta dos tecidos pouco vascularizados 21,22 . Desse modo, na criança, o volume de distribuição do compartimento central (343 ml.kg -1 ) é maior quando comparado ao do adulto (228 ml.kg -1 ).…”

Section: Discussionunclassified

“…Propofol concentration curves in children are better described by a tricomparmental model, with a short initial half-life (1.5 to 4.2 minutes), due to redistribution process, followed by a second phase (9.3 to 56 minutes) associated to high metabolic clearance in the liver and in other large distribution volume sites. The third and final phase (209 to 475 minutes) reflects the slow elimination process of less vascularized tissues 21,22 . So, in children, central compartment distribution volume (343 ml.kg -1 ) is higher as compared to adults (228 ml.kg -1 ).…”

Section: Discussionmentioning

confidence: 99%

Método simplificado para manutenção da concentração sangüínea de propofol em nível aproximadamente constante, associado ao óxido nitroso no paciente pediátrico

Vianna¹,

Vilela²,

Cordon³

et al. 2002

Rev. Bras. Anestesiol.

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“…Until correct positioning of the laryngeal mask airway was confirmed, all children received an F i O 2 of 1.0 and thereafter an F i O 2 of 0.5 for the rest of the study. General anaesthesia was induced with a propofol target controlled infusion system for children (Alaris Asena PK, Alaris Medical Systems, Inc., San Diego, CA) [5,6]. For induction of anaesthesia, a dose calculated to obtain a plasma concentration of 7 lg.ml )1 propofol was administered until a laryngeal mask airway (LMA-ProSeal, LMA North America, Inc., San Diego, CA) was inserted (size 2 for children 15-20 kg and size 2.5 for children 20-30 kg).…”

Section: Methodsmentioning

confidence: 99%

The effect of caudal block on functional residual capacity and ventilation homogeneity in healthy children*

Ungern‐Sternberg¹,

Regli²,

Frei³

et al. 2006

Anaesthesia

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SummaryCaudal block results in a motor blockade that can reduce abdominal wall tension. This could interact with the balance between chest wall and lung recoil pressure and tension of the diaphragm, which determines the static resting volume of the lung. On this rationale, we hypothesised that caudal block causes an increase in functional residual capacity and ventilation distribution in anaesthetised children. Fifty-two healthy children (15-30 kg, 3-8 years of age) undergoing elective surgery with general anaesthesia and caudal block were studied and randomly allocated to two groups: caudal block or control. Following induction of anaesthesia, the first measurement was obtained in the supine position (baseline). All children were then turned to the left lateral position and patients in the caudal block group received a caudal block with bupivacaine. No intervention took place in the control group. After 15 min in the supine position, the second assessment was performed. Functional residual capacity and parameters of ventilation distribution were calculated by a blinded reviewer. Functional residual capacity was similar at baseline in both groups. In the caudal block group, the capacity increased significantly (p < 0.0001) following caudal block, while in the control group, it remained unchanged. In both groups, parameters of ventilation distribution were consistent with the changes in functional residual capacity. Caudal block resulted in a significant increase in functional residual capacity and improvement in ventilation homogeneity in comparison with the control group. This indicates that caudal block might have a beneficial effect on gas exchange in anaesthetised, spontaneously breathing preschool-aged children with healthy lungs. Various anaesthetic agents, airway instrumentations and ventilation strategies are used in infants and children undergoing anaesthesia. Each of these factors may affect functional residual capacity (FRC), which is one of the most important respiratory parameters of gas exchange. There is very little information available on the magnitude and the relative contribution of these different factors (e.g. neuroaxial blockade with local anaesthetics) on functional residual capacity in anaesthetised children [1][2][3][4].Muscle relaxation induced by caudal epidural anaesthesia with bupivacaine decreases abdominal muscle tone while sparing the muscles of the respiratory system (diaphragm, intercostal muscles). This could interact with the balance between chest wall and lung recoil pressure and tension of the diaphragm, which determines the static resting volume of the lung. This alteration of the equilibrium between the thoracal and abdominal compartments might affect the functional residual capacity and ventilation homogeneity of the lungs. This study

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The Pharmacokinetics of Propofol in Children Using Three Different Data Analysis Approaches

Cited by 297 publications

References 0 publications

Propofol decreases cerebral blood flow velocity in anesthetized children

Propofol decreases cerebral blood flow velocity in anesthetized children

Método simplificado para manutenção da concentração sangüínea de propofol em nível aproximadamente constante, associado ao óxido nitroso no paciente pediátrico

The effect of caudal block on functional residual capacity and ventilation homogeneity in healthy children*

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