Predictive performance of ‘Servin's formula’ during BIS®-guided propofol-remifentanil target-controlled infusion in morbidly obese patients

Albertin, A.; Poli, D.; Colla, Luca La; Gonfalini, M.; Túri, Sándor; Pasculli, Nicola; Colla, G. La; Bergonzi, P. C.; Dedola, E.; Fermo, Isabella

doi:10.1093/bja/ael321

Cited by 45 publications

(15 citation statements)

References 35 publications

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“…The approved label for propofol indicates that dosing should be determined on a mg/kg total body weight (TBW) basis for all patients (17). However, caution is advised when dosing obese patients by this method as it may lead to higher than expected plasma concentrations and an increased risk of deleterious haemodynamic side effects (18)(19)(20)(21)(22)(23)(24). Additionally, anecdotal evidence from anesthetists suggests the current dosing label is unsuitable for the obese population as it results in deeper anesthesia and increased time to awakening (personal communication).…”

Section: Introductionmentioning

confidence: 99%

Encouraging the Move Towards Predictive Population Models for the Obese Using Propofol as a Motivating Example

et al. 2009

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Section: Introductionmentioning

confidence: 99%

Encouraging the Move Towards Predictive Population Models for the Obese Using Propofol as a Motivating Example

et al. 2009

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“…We used CBW for the calculation of the dosage of propofol [27]. BIS may be used for the estimation of dosages of propofol in the morbidly obese [29]. In the obese the dosing of inhalation anaesthetics may be similar to dosing in non-obese patients, and may be based on the age of the patient [30,31].…”

Section: Discussionmentioning

confidence: 99%

Porównanie wartości BIS podczas całkowitego znieczulenia dożylnego z zastosowaniem propofolu i znieczulenia wziewnego sewofluranem u otyłych pacjentów

Gaszyński

Wieczorek²

2016

Anaesthesiol Intensive Ther

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Background: Intraoperative awareness is a rarely occurring phenomenon. Obesity is considered as one of the factors increasing the probability of intraoperative awareness due to problems with the dosing of anaesthetics. In a randomized prospective study we compared bispectral index (BIS) recordings during propofol-based total intravenous anaesthesia (TIVA) and sevoflurane-based inhalation anaesthesia in morbidly obese patients as a sign of possible intraoperative awareness. Methods: 120 morbidly obese patients were randomly allocated into two subgroups: TIVA or SEVO. Propofol TIVA was performed following the Servin formula, while sevoflurane was administered based on the age of the patients. The physician administering anaesthesia was blinded to the BIS recordings while the evaluation of the depth of anaesthesia was conducted based on the clinical symptoms of adequate anaesthesia. BIS recordings were evaluated for periods of BIS > 60. Blinded structured interviews were conducted 2 hours after anaesthesia was administrated. Results: The incidence of BIS > 60 occurred in 90% vs. 91.67% of patients while the mean duration of periods of BIS > 60 was 13.74 ± 21.74% vs. 14.21 ± 18.78% of the duration of anaesthesia in TIVA and SEVO groups, respectively (P > 0.05). There was no correlation between the BMI value and the duration of elevated BIS values observed during anaesthesia in both studied methods of anaesthesia, nor between the total time of anaesthesia and the duration of elevated BIS values above 60 in this study. No patient complained of intraoperative awareness when asked in the post-operative period, probably due to the administration of midasolam. Conclusions: Although the incidence of BIS > 60 are very common in obese patients, true awareness during anaesthesia infrequent in this group of patients despite the type of anaesthesia, whether intravenous or inhalation.

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“…Inicialmente el desempeño de los dispositivos TCI se consideró aceptable con MDPE% < ± 20% y MDAPE% del 20-40% 39 ; recientemente 40 se acepta como buen desempeño MDPE% < ± 15% y MDAPE% < 25%, condición que cumple el TCI sevoflurane © (tabla 3) [39][40][41][42][43] .…”

Section: Discussionunclassified

Desempeño predictivo y clínico de un dispositivo target-controlled infusion para sevofluorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado

Arana¹,

Monzón²,

Gómez³

et al. 2014

Revista Colombiana de Anestesiología

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r e v c o l o m b a n e s t e s i o l . 2 0 1 4;4 2(4):255-264 Revista Colombiana de Anestesiología Colombian Journal of Anesthesiology w w w . r e v c o l a n e s t . c o m . c o Investigación científica y tecnológica Desempeño predictivo y clínico de un dispositivo target-controlled infusion para sevofluorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado

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Predictive performance of ‘Servin's formula’ during BIS®-guided propofol-remifentanil target-controlled infusion in morbidly obese patients

Cited by 45 publications

References 35 publications

Encouraging the Move Towards Predictive Population Models for the Obese Using Propofol as a Motivating Example

Encouraging the Move Towards Predictive Population Models for the Obese Using Propofol as a Motivating Example

Porównanie wartości BIS podczas całkowitego znieczulenia dożylnego z zastosowaniem propofolu i znieczulenia wziewnego sewofluranem u otyłych pacjentów

Desempeño predictivo y clínico de un dispositivo target-controlled infusion para sevofluorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado

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