Evaluation of Influencing Variables in Awakening Concentration and Concentration at Ventilatory Maladjustment of Propofol TCI (Targeted Controlled Infusion) Targeted at the Effector Site
Summary
Age has been related to awakening propofol concentration at effector site of TCI, but not to the loss of consciousness concentration, neither to the concentration of ventilatory maladjustment during surgery, that can be interpreted as a sign of light anesthesia and lead to awareness.
This study aims to determinate the incidence and the propofol TCI concentration at the effector site, in patients undergoing general anaesthesia without NBDs, of any patients ventilator maladjustment, defined as coughing or return of spontaneous ventilation during surgery.
Description
Target-Controlled-Infusion (TCI), estimating the effect-size concentration (Ce) of propofol and its elimination time with a computerized system, provides the anaesthesiologist useful information to guide anaesthesia.
Although the correlation between propofol at the effector site at loss of consciousness (Ce LOC) and age is still debated with contrasting results, the correlation between propofol at the effector site at return of consciousness (Ce ROC) and age is well established, and some authors suggested that, due also for age-related changes in both pharmacokinetics and pharmacodynamics of propofol, its dosage should be reduced in elderly patients.
Lowering propofol dosage however, can lead to an higher incidence of awareness during general anaesthesia, even if anaesthesia management is guided by consciousness monitors.
Awareness during anaesthesia has recently been defined not as a binary phenomenon, but as a graded spectra of states and, during general anaesthesia without using neuromuscular blocking drugs (NBDs), body movement on the operating table can be taken as an indication of increasing probability of consciousness or 'light' anaesthesia.
Hence, this study aims to determinate the incidence and the propofol TCI concentration at the effector site, in patients undergoing general anaesthesia without NBDs, of any patients ventilator maladjustment, defined as coughing or return of spontaneous ventilation during surgery.
Study Design
Conditions
Awareness, Anesthesia
Intervention
We do not modify the normale general anesthesia delivery. We note the concentration of propofol at the effector site of ventilator maladjustment and awakening
Location
ULSS 2 Marca Trevigiana
Treviso
Tv
Italy
31100
Status
Recruiting
Source
University of Padua
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT04129112
- ClinicalTrials.gov processed this data on October 18, 2019
Published on BioPortfolio: 2019-10-21T12:45:20-0400
Clinical Trials
Determination of Propofol Target Concentration for Young and Elderly by Suppression Rate Analysis
Propofol's dose-response curve is know for the average adult but propofol's plasmatic concentration under total intravenous anesthesia differences between young and elderly must be modeled...
Continuous and Discontinuous Determination of Propofol Concentration in Breathing Gas
This study should compare the propofol concentration in breathing gas and in plasma (before and) after lung passage. Propofol concentrations in breathing gas are continuously measured by a...
Use of a Remifentanil-propofol Mixture in Patients Undergoing Breast Cancer Surgery
Co-administration of propofol and remifentanil is considered to be an ideal total intravenous anesthesia technique, which is widely used in induction and maintenance of general anesthesia....
Slow Stepwise Propofol TCI Induction for Titration Anesthesia Maintenance
The purpose of this study is to determine if a slow stepwise propofol TCI induction with Marsh model (Ke0 0.26), allows for an accurate estimation of the effect site concentration required...
The Effect of Anxiety and Depression on Propofol During Induction
109 consecutive female patients, 18-65 years old, American Society of Anesthesiologists (ASA) physical status I or II, scheduled for gynecological surgery under general anesthesia will be ...
PubMed Articles
The propofol dose requirement and the emergence time are affected by antiepileptic use. The effects on anesthesia of the number and kind of antiepileptic agents have not been reported. We investigated...
Propofol is commonly used with remifentanil for induction of general anesthesia (GA); however, it often leads to hypotension. Intraoperative hypotension is associated with postoperative adverse events...
Propofol relaxes isolated rat aorta through BK activation.
Propofol is an intravenous anesthetic that can be used for the induction and maintaining of anesthesia. In the present study, it was aimed to investigate the mechanism of vasodilator action of propofo...
Intravenous Propofol Versus Volatile Anesthetics For Stroke Endovascular Thrombectomy.
The choice of anesthetic technique for ischemic stroke patients undergoing endovascular thrombectomy is controversial. Intravenous propofol and volatile inhalational general anesthetic agents have dif...
Functional endoscopic sinus surgery is a common procedure for sinonasal disease, frequently performed in the outpatient setting. General anesthesia maintained with total intravenous anesthesia (TIVA) ...
Medical and Biotech [MESH] Definitions
Delayed Emergence From Anesthesia
Abnormally slow pace of regaining CONSCIOUSNESS after general anesthesia (ANESTHESIA, GENERAL) usually given during surgical procedures. This condition is characterized by persistent somnolence.
Anaerobic Threshold
The oxygen consumption level above which aerobic energy production is supplemented by anaerobic mechanisms during exercise, resulting in a sustained increase in lactate concentration and metabolic acidosis. The anaerobic threshold is affected by factors that modify oxygen delivery to the tissues; it is low in patients with heart disease. Methods of measurement include direct measure of lactate concentration, direct measurement of bicarbonate concentration, and gas exchange measurements.
Anesthetics, General
Agents that induce various degrees of analgesia; depression of consciousness, circulation, and respiration; relaxation of skeletal muscle; reduction of reflex activity; and amnesia. There are two types of general anesthetics, inhalation and intravenous. With either type, the arterial concentration of drug required to induce anesthesia varies with the condition of the patient, the desired depth of anesthesia, and the concomitant use of other drugs. (From AMA Drug Evaluations Annual, 1994, p.173)
Propofol
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
Propofol Infusion Syndrome
Rare and often fatal drug complication which affects patients undergoing long-term treatment with high doses of PROPOFOL. It is characterized by METABOLIC ACIDOSIS; HYPERLIPIDEMIA; RHABDOMYOLYSIS; cardiovascular CIRCULATORY COLLAPSE; CARDIAC FAILURE; and KIDNEY FAILURE.
More From BioPortfolio on "Evaluation of Influencing Variables in Awakening Concentration and Concentration at Ventilatory Maladjustment of Propofol TCI (Targeted Controlled Infusion) Targeted at the Effector Site"
Quick Links
Advanced Search |
Login |
Subscribe |
RSS 
BioPortfolio Twitter Channels (200+ Accounts)
LinkedIn