Propofol and remifentanil pharmacodynamic interaction during orthopedic surgical procedures as measured by effects on bispectral index

Röpcke, Heiko; Könen-Bergmann, Michael; Cuhls, Monju; Bouillon, Thomas; Hoeft, Andreas

doi:10.1016/s0952-8180(01)00255-0

Cited by 52 publications

(21 citation statements)

References 23 publications

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“…Both groups were similar in age, height and weight. There was no significant difference in the mean total propofol doses delivered (induction and maintenance combined) between Diprivan ® and generic propofol groups: 90 (30) µg kg Ϫ1 min Ϫ1 vs. 90 (20) µg kg Ϫ1 min Ϫ1 (mean Ϯ standard deviation), nor in time to emergence (end of propofol infusion to extubation) or the incidence of respiratory adverse effects (Table 2). There was also no difference in the mean maintenance propofol doses in both groups: 70 (20) µg kg Ϫ1 min Ϫ1 vs. 70 (20) µg kg Ϫ1 min Ϫ1 .…”

Section: Resultsmentioning

confidence: 98%

“…Also, propofol demonstrated stronger correlation to BIS than propofol/fentanyl combination (R ϭ Ϫ0.33 vs. Ϫ0.18) [16]. Opioids have a synergistic effect with propofol and can contribute to lower propofol requirements [20]. Opioids however are also known to significantly increase the plasma concentration of targeted propofol concentrations [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

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A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with Diprivan®

Olufolabi

Gan

Lacassie

et al. 2006

European Journal of Anaesthesiology

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with Diprivan®

Olufolabi

Gan

Lacassie

et al. 2006

European Journal of Anaesthesiology

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“…All opioids act similarly in synergism with both volatile (Lang et al 1996) and intravenous hypnotics (Ropcke et al 2001) and remifentanil is not an exception to this general rule.…”

Section: Interactions With Hypnoticsmentioning

confidence: 95%

Remifentanil and Other Opioids

Servin

Billard

Handbook of Experimental Pharmacology

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Most opioids used in anaesthesia are of the anilidopiperidine family, including fentanyl, alfentanil, sufentanil and remifentanil. While all share similar pharmacological properties, remifentanil, the newest one, is probably the most original, which is the reason this review focusses especially on this drug. Remifentanil is a potent mu-agonist that retains all the pharmacodynamic characteristics of its class (regarding analgesia, respiratory depression, muscle rigidity, nausea and vomiting, pruritus, etc.) but with a unique pharmacokinetic profile that combines a short onset and the fastest offset, independent of the infusion duration. Consequently, it offers a unique titratability when its effects need to be quickly achieved or suppressed, but it requires specific drug delivery schemes such as continuous infusion, target-controlled infusion and anticipated postoperative pain treatment. Kinetic differences between opioids used in anaesthesia and some clinical uses of remifentanil are reviewed in this chapter.

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“…These include influence of electromyographic (EMG) activity [5,14,18], electrical or mechanical artifacts from medical devices [23,38,81], time delay [113], specific clinical conditions such as hypovolaemia, hypotension, cerebral ischaemia, hypoglycaemia and hypothermia [23], inter-individual variability of baseline EEG characteristics [68,111] and types of drugs [44]. In addition, opioids may interfere with the EEG-signal during administration of the hypnotic agent [26,50,63,67,84,88] thus rendering the reliability of indices during multidrug administration questionable.…”

Section: Controlled Variablesmentioning

confidence: 99%

Automation of anaesthesia: a review on multivariable control

Chang

Syafiie

Kamil

et al. 2014

J Clin Monit Comput

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Anaesthesia is a multivariable problem where a combination of drugs are used to induce desired hypnotic, analgesia and immobility states. The automation of anaesthesia may improve the safety and cost-effectiveness of anaesthesia. However, the realization of a safe and reliable multivariable closed-loop control of anaesthesia is yet to be achieved due to a manifold of challenges. In this paper, several significant challenges in automation of anaesthesia are discussed, namely model uncertainty, controlled variables, closed-loop application and dependability. The increasingly reliable measurement device, robust and adaptive controller, and better fault tolerance strategy are paving the way for automation of anaesthesia.

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Propofol and remifentanil pharmacodynamic interaction during orthopedic surgical procedures as measured by effects on bispectral index

Cited by 52 publications

References 23 publications

A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with Diprivan®

A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with Diprivan®

Remifentanil and Other Opioids

Automation of anaesthesia: a review on multivariable control

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