Prediction of effect-site concentration of sufentanil by dose–response target controlled infusion of sufentanil and propofol for analgesic and sedation maintenance in burn dressing changes

Chen, Lingyang; Wang, Mingcang; Xiang, Haifei; Lin, Xianju; Cao, Donghang; Ye, Liyue

doi:10.1016/j.burns.2013.08.002

Cited by 16 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many opioids were added to propofol with different degrees of success. Fentanyl,[ 20 ] alfentanil,[ 11 12 20 ] sufentanil,[ 22 23 ] and remifentanil[ 10 24 ] were all used. Alfentanil is less lipid soluble than fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Sultan

2014

Saudi J Anaesth

View full text Add to dashboard Cite

Context:Many techniques are used for sedation of colonoscopies. Patient-controlled sedation (PCS) is utilizing many drugs or drug combinations.Aims:The aim of this study is to compare the safety and feasibility of propofol/remifentanil versus propofol/alfentanil given to sedate patients undergoing outpatient colonoscopies through a patient-controlled technique.Settings and Design:Controlled randomized and double-blind study.Materials and Methods:A total of 80 patients were randomly divided into two groups; PA group received a combination of propofol/alfentanil and PR group received propofol/remifentanil combination. Patients were monitored for heart rate (HR), blood pressure (BP), oxygen saturation, and Ramsay sedation scale (RSS). Times of the following events were recorded; initiation of sedation, insertion and removal of the colonoscope, recovery and discharge. Five intervals were calculated; time to sedation, procedure time, postprocedure time, procedure room time, and postanesthesia care unit (PACU) time. Endoscopist and patient satisfaction scores were obtained.Statistical Analysis Used:Unpaired Student's t-test was used to compare between the two groups. Paired Student's t-test was used to compare baseline readings with readings after 30 min of sedation in the same group when needed.Results:Both groups showed slowing of the HR and decrease in mean arterial BP. HR and mean arterial BP were significantly lower 5 and 10 min after initiation of sedation in PR group when compared with PA group. Both HR and mean arterial BP returned to presedation readings 30 min after initiation of sedation in PR group but not in PA group. No differences between the two groups concerning oxygen saturation, RSS, endoscopist and patient satisfaction scores. Postprocedure and PACU times were significantly prolonged in PA group.Conclusion:PCS with either remifentanil/propofol or alfentanil/propofol for patients undergoing outpatient colonoscopy is safe and feasible. Remifentanil/proofol has more beneficial advantages in this setting secondary to its more rapid clearance.

show abstract

Section: Discussionmentioning

confidence: 99%

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Sultan

2014

Saudi J Anaesth

View full text Add to dashboard Cite

show abstract

“…98 Indeed, a combination of propofol 1.2 mg ml À1 and sufentanil 0.456 ng ml À1 has been successfully used for conscious sedation during (very painful) burn wound dressing changes, without respiratory depression and with good doctor and patient satisfaction scores in 95% of patients. 99 Studies of the interaction between propofol and alfentanil on loss of response to eye lash reflex, laryngoscopy, and various surgical stimuli in patients undergoing elective surgery showed supra-additive interactions. 100 101 However, it has also been shown that alfentanil amplifies the depressant effect of propofol on blood pressure and does therefore not contribute to haemodynamic stability during induction.…”

Section: Anaesthetic-opioid Interactionsmentioning

confidence: 99%

Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current knowledge and how it can be used to optimize anaesthetic drug administration

Berg

Vereecke

Proost

et al. 2017

British Journal of Anaesthesia

View full text Add to dashboard Cite

This review describes the basics of pharmacokinetic and pharmacodynamic drug interactions and methodological points of particular interest when designing drug interaction studies. It also provides an overview of the available literature concerning interactions, with emphasis on graphic representation of interactions using isoboles and response surface models. It gives examples on how to transform this knowledge into clinically and educationally applicable (bedside) tools.

show abstract

“…Propofol TCI has been used in a variety of settings, including endoscopy, 98 bronchoscopy, 99 and dental procedures. 100 Opioid TCI has been utilized in various settings as well, including sufentanil for burn dressing changes, 101 and remifentanil for awake intubation, 102 and colonoscopy. 103 Whether sedation with TCI is superior to manually controlled sedation is not clear.…”

Section: Target-controlled Infusionmentioning

confidence: 99%

Monitoring and delivery of sedation

Sheahan

Mathews²

2014

British Journal of Anaesthesia

View full text Add to dashboard Cite

Sedation for medical procedures is provided in a variety of clinical settings by medical personnel with differing levels of education and training. Although generally a safe practice, there is a degree of morbidity and mortality associated with sedation practice. Monitoring standards continue to be refined by professional societies with the goal of improving care. The depth of sedation should be monitored with clinical criteria. Processed electroencephalographic monitors currently do not contribute significantly to sedation care. Monitoring ventilation using pulse oximetry should be abandoned for more direct methods, such as capnography-transcutaneous carbon dioxide, respiratory acoustical and thoracic impedance monitoring could also play a role. Propofol has become widely utilized for sedation, although there are concerns about its margin of safety and synergistic interactions with other agents. Dexmedetomidine and propofol/ketamine also have utility. Patient-controlled sedation pumps and target-controlled infusion devices have been developed to improve patient care and satisfaction. A computer-assisted propofol sedation device to be used by non-anaesthesiologists has been approved in the USA by the Food and Drug Administration. More computer-assisted sedation delivery devices are likely to be developed, but their clinical utility is unclear.

show abstract

Prediction of effect-site concentration of sufentanil by dose–response target controlled infusion of sufentanil and propofol for analgesic and sedation maintenance in burn dressing changes

Cited by 16 publications

References 23 publications

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current knowledge and how it can be used to optimize anaesthetic drug administration

Monitoring and delivery of sedation

Contact Info

Product

Resources

About