Low dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion

Yumura, Junko; Koukita, Yoshihiko; Fukuda, Ken‐ichi; Kaneko, Yuzuru; Ichinohe, Tatsuya

doi:10.1007/s00540-008-0728-x

Cited by 6 publications

(3 citation statements)

References 25 publications

(34 reference statements)

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“…In the operating room, intravenous access was secured and routine monitoring was established using ECG, non-invasive blood pressure and oxygen saturation (Dräger Infinity Delta; Dräger Medical AG&Co.KGoA, Lübeck, Germany). After preoxygenation with 100% oxygen for 3 min, anaesthesia was induced with intravenous fentanyl 1 lg.kg )1 and 1% propofol 3-5 mg.kg )1 [12,13]. On loss of verbal contact and eyelash reflex [14], the anaesthetist checked if ventilation via facemask was possible, and then inserted the first airway device according to the manufacturers' instructions.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the i‐gel and the LMA‐Unique laryngeal mask airway in patients with mild to moderate obesity during elective short‐term surgery

et al. 2011

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SummaryThe aim of our study was to compare leakage pressure, ease and time of insertion of the i-gel and the LMA-Unique laryngeal mask airway in patients with mild to moderate obesity during elective short-term surgery. In this prospective, randomised crossover trial, we included patients with a body mass index (BMI) > 25 and < 35 kg.m )2 , and , age > 18 years, undergoing elective surgery in the supine position with an expected duration of surgery < 2 h. Leakage pressures, insertion difficulty, time and number of insertion attempts were evaluated. We included 50 patients consisting of 29 mildly (BMI > 25 and < 30 kg.mg) and 21 moderately (BMI > 30 and < 35 kg.mg

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Section: Methodsmentioning

confidence: 99%

Comparison of the i‐gel and the LMA‐Unique laryngeal mask airway in patients with mild to moderate obesity during elective short‐term surgery

et al. 2011

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“…We found that the CP 50 s in the Supreme TM , ProSeal TM , I-gel TM and Laryngeal Tube Suction II TM groups were 5.8, 4.9, 5.7 and 5.5 µg/ml, respectively. Previous studies reported that the use of low dose fentanyl combined with propofol could markedly reduce the blood concentration of propofol necessary to suppress body movement during LMA insertion 15,16 . Therefore, we used intravenous fentanyl 2 µg/kg for 5 minutes before…”

Section: Discussionmentioning

confidence: 99%

Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial

Kovitwanawong

Tangcharoenwathanakul

Oofuvong

et al. 2023

J Health Sci Med Res

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Objective: We aimed to determine the plasma concentration 50 (CP50) of propofol target controlled infusion (TCI) for successful insertion of four types of supraglottic airway devices (SGD). Material and Methods: This prospective parallel randomized controlled, double blinded, superiority trial was conducted in June 2012 following approval by the Ethics Committee of the Faculty of Medicine, Prince of Songkla University, Thailand. Effect-site concentrations (Ce) of propofol TCI were determined by the modified Dixon’s up-and-down method. After equilibration was established between the plasma and effect-site concentrations, a SupremeTM, ProSealTM(control groups), I-gelTM or Laryngeal Tube Suction IITM devices were inserted. The CP50 was determined by dose response logistic curves presented as means and 95% confidence intervals (CI). The General Estimating Equation was used to determine factors associated with hemodynamic changes. Results: The Ces of TCI propofol requirements in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8, 4.8, 5.6, and 5.8 μg/ml, respectively (effect size [95% CI]: 0.22 [0.06, 0.51], p-value 0.036). The CP50 [95% CIs] in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8 [-0.01, 11.6], 4.9 [3.3, 6.5], 5.7 [5.0, 6.3] and 5.5 [4.7, 6.4] μg/ml, respectively. Heart rates and systolic blood pressure were significantly higher in the Laryngeal Tube Suction IITM group than in the ProSealTM (p-value<0.01) and I-gelTMgroups (p-value<0.01 Conclusion: The ProSealTM and I-gelTM are preferred over the SupremeTM and Laryngeal Tube Suction IITM devices due to the lower CP50 and hemodynamic changes.

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“…Similar study was done by Yumura et al . [ 15 ] suggested that EC 50 of propofol for LMA insertion was decreased by supplementing 0.25 μg/kg fentanyl without haemodynamic or respiratory depression.…”

Section: Discussionmentioning

confidence: 99%

Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant

et al. 2015

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Background and Aims:Insertion of laryngeal mask airway (LMA) requires adequate depth of anaesthesia, which provides jaw relaxation and suppression of upper airway reflexes. Propofol can provide these conditions especially when combined with narcotics. This study had been designed to find out the effect-site concentration (EC50) of propofol using target controlled infusion (TCI) when fentanyl or morphine is added as an adjuvant.Methods:Patients satisfying inclusion criteria were divided into fentanyl and morphine groups. Intravenous glycopyrrolate 0.2 mg was given 15 min before induction. Patients were given either intravenous fentanyl (1 μg/kg) or morphine (0.1 mg/kg) before propofol infusion depending on the group. Patients in either groups were induced by continuous infusion of propofol at an EC of 6 μg/mL by TCI with Schneider pharmacokinetic model. The LMA supreme of appropriate size was inserted 1 min after achieving target concentration. Patient movement at LMA insertion or within 1 min of insertion was classified as failure. For subsequent patients, the target EC was increased/decreased depending on previous patients' response. Dixons up and down method was used to determine the EC50. The EC50 is defined as the mean of crossover midpoints in each pair of failure to success.Results:The EC50 of propofol in the fentanyl group for LMA insertion was 5.95 ± 0.6 μg/ml and morphine group was 5.75 ± 0.8 μg/ml. No significant difference in insertion conditions was noticed between the two groups (P = 0.3).Conclusion:We conclude that there was no significant difference in propofol EC50 for insertion of LMA and insertion conditions were similar when fentanyl or morphine was used as an adjuvant drug.

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Low dose of fentanyl reduces predicted effect-site concentration of propofol for flexible laryngeal mask airway insertion

Abstract: The propofol EC(50) for FLMA insertion was decreased by supplemental 0.25 microg x kg(-1) fentanyl without BIS, hemodynamic, or respiratory depression.

Cited by 6 publications

References 25 publications

Comparison of the i‐gel and the LMA‐Unique laryngeal mask airway in patients with mild to moderate obesity during elective short‐term surgery

Comparison of the i‐gel and the LMA‐Unique laryngeal mask airway in patients with mild to moderate obesity during elective short‐term surgery

Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial

Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant

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