Purpose: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass.
Methods: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10) or off-pump coronary artery bypass graft (group, n=10) coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 microg/mL). Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant.
Results: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 +/- 117 vs. 216 +/- 85 min, p = 0.04). Patients undergoing cardiopulmonary bypass had shorter biological (1.82 +/- 0.5 vs. 3.67 +/- 1.15 h, p < 0.01) and terminal elimination (6.27 +/- 1.29 vs. 10.5h +/- 2.18, p < 0.01) half-life values, as well as higher total plasma clearance (28.36 +/- 11.40 vs.18.29 +/- 7.67 mL/kg/min, p = 0.03), compared to patients in the off-pump coronary artery bypass graft group.
Conclusion: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666455 | PMC |
| http://dx.doi.org/10.1590/s1807-59322009000300012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Remimazolam, a novel drug, for safe and effective endoscopic sedation.
Clin Endosc
January 2025
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
Article Synopsis
- Remimazolam is a new type of benzodiazepine that has rapid onset and short duration, making it great for sedation during endoscopy.
- It presents a safer option compared to older sedatives like midazolam and propofol, with fewer side effects like low blood pressure, heart rate issues, and breathing problems.
- The article highlights remimazolam's benefits, such as easy administration, fast recovery, and low residual sedation, which can enhance patient safety and efficiency in clinical endoscopy.
Efficacy and Safety of Ciprofol for Anesthesia in Painless Colonoscopy with Varying Body Mass Indices Patients: A Prospective, Single-Center, Observational Study.
Drug Des Devel Ther
January 2025
Department of Anesthesiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People's Republic of China.
Background: Ciprofol, a novel intravenous anesthetic derived from propofol, exhibits high lipophilicity. Its pharmacokinetics and pharmacodynamics may vary across different body mass indices (BMI) categories, but data on its optimal dosing as well as its safety and efficacy during colonoscopy anesthesia in varying BMI groups are lacking.
Objective: To evaluate the efficacy and safety of ciprofol during anesthesia for painless colonoscopy in patients with varying BMI, and to explore the correlation between BMI and induction dose.
Validation of a method for estimating pulmonary dead space in ventilated beagles to correct exhaled propofol concentration in mixed air.
BMC Vet Res
January 2025
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Background: Mixed exhaled air has been widely used to determine exhaled propofol concentrations with online analyzers, but changes in dead space proportions may lead to inaccurate assessments of critical drug concentration data. This study proposes a method to correct propofol concentration in mixed air by estimating pulmonary dead space through reconstructing volumetric capnography (Vcap) from time-CO and time-volume curves, validated with vacuum ultraviolet time-of-flight mass spectrometry (VUV-TOF MS).
Methods: Existing monitoring parameters, including time-volume and time-CO curves, were used to determine Vcap.
Advances in Canine Anesthesia: Physiologically Based Pharmacokinetic Modeling for Predicting Propofol Plasma Profiles in Canines with Hepatic Impairment.
Pharmaceuticals (Basel)
December 2024
Department of Veterinary Medicine, Universidade Federal de Lavras, Lavras 37200-900, MG, Brazil.
: A PBPK model allows the prediction of the concentration of drug amounts in different tissues and organs over time and can be used to simulate and optimize different therapeutic protocols in healthy and sick individuals. The objective of this work was to create a PBPK model to predict propofol doses for healthy canines and canines with hepatic impairment. : The study methodology was divided into two major phases, in which the first phase consisted of creating the PBPK model for healthy canines, and in the second phase, this model was adjusted for canines with hepatic impairment.
View Article and Find Full Text PDFThe median effective dose of ciprofol combined with sufentanil in suppressing the laryngeal mask airway insertion response in both young and older adult patients.
BMC Anesthesiol
December 2024
Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China.
Background: Ciprofol, a novel intravenous anesthetic, exhibits similar sedation mechanisms and pharmacokinetic properties to propofol. However, ciprofol demonstrates greater potency and is associated with reduced injection pain compared to propofol. Given the varying sensitivities to anesthetic agents across different age groups, this study aims to determine the median effective dose (ED) of ciprofol required to suppress the laryngeal mask airway (LMA) insertion response in both young and older adult patients, as well as to assess its potential adverse reactions.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!