Some heightened sensitivity

Hudson, Andrew E.; Proekt, Alex

doi:10.1093/bja/aev168

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…It could be so because the probability of moving in one direction need not be the same as the probability of moving in the opposite direction. [ 19 ] Hence, the patient might recover at a lower concentration of an anaesthetic than that required for anaesthetic induction. Other parameters such as age, gender, BMI and opioid administration may influence the Ce.…”

Section: Discussionmentioning

confidence: 99%

Effect site concentration of propofol at induction and recovery of anaesthesia - A correlative dose-response study

2018

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Background and Aims:Sound knowledge about effect site concentration (Ce) of propofol aids in smooth induction, maintenance and early recovery. We studied the correlation between Ce of propofol at loss of response to verbal command and recovery concentration using target-controlled infusion (TCI) in Indian patients who underwent spine surgeries.Methods:Ninety patients undergoing spine surgeries were included. Total intravenous anaesthesia (TIVA) technique with TCI for propofol using modified Marsh model was used. Entropy and neuromuscular transmission were used. Ce at induction and recovery and the corresponding state entropy (SE) values were noted.Results:The mean propofol Ce and SE at induction were 2.34 ± 0.24 μg/ml and 52 ± 8, respectively. The mean propofol Ce and SE at recovery were 1.02 ± 0.22 μg/ml and 86.80 ± 2.86, respectively. The Ce at recovery was approximately 50% of the induction value. The correlation coefficient 'r' between Ce at induction and recovery was 0.56. The mean infusion dose of propofol during the maintenance period was 81 ± 14.33 μg/kg/min. The average induction dose of propofol was 1.17 ± 0.2 mg/kg.Conclusion:There is a positive correlation between Ce at induction and recovery. Ce for recovery may have to be set at a lower level during TCI-TIVA and appropriately infusion should be stopped for early recovery. The induction and maintenance doses of propofol are lower than the recommended doses. Data emphasise the need for pharmacokinetic model based on our population characteristics.

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Section: Discussionmentioning

confidence: 99%

Effect site concentration of propofol at induction and recovery of anaesthesia - A correlative dose-response study

2018

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“…9 This is highlighted in an editorial by Hudson and Proekt. 10 Age-dependent changes in the EEG response to anaesthesia also occur in children, as demonstrated for sevoflurane by Akeju and colleagues; 11 this phenomenon has implications for EEG-based monitors of anaesthetic depth in both the young and the elderly. The impact of the unique pharmacological profile of ketamine on its EEG signature is described in a study by Pal and colleagues, 12 who show that ketamine, like other general anaesthetics, suppresses high-frequency γ activity and promotes a breakdown in cortical coherence.…”

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confidence: 92%

Memory and awareness in anaesthesia

Kurata

Hemmings

2015

British Journal of Anaesthesia

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The 9th International Symposium on Memory and Awareness in Anesthesia (MAA9) was held in Tokyo, Japan on June 20-23, 2014, attracting over 70 delegates from around the world. It was chaired by Jiro Kurata, from the Tokyo Medical and Dental University, and was jointly sponsored by the British Journal of Anaesthesia to support research activities in the fields of awareness during anaesthesia, neurobiological mechanisms of general anaesthesia, consciousness, and memory. This topic complements the recently published National Audit Project NAP5 survey of accidental awareness under general anaesthesia conducted in the UK in 2012 and published in the British Journal of Anaesthesia last year. 1-3 The present British Journal of Anaesthesia special issue on Memory and Awareness in Anaesthesia was planned by Hugh Hemmings, a co-organizer of MAA9, to present the most current findings and views on topics from selected presentations during the meeting, in addition to submissions in response to an open call for papers. All the MAA9 abstracts are also included in this special on-line-only issue. Details of the MAA9 programme can be found at the conference website (http://maa9.umin.jp/). The scope of previous MAA symposia has ranged from the neuroscience of anaesthetic action, memory, and consciousness to the clinical aspects of awareness during anaesthesia. The MAA9 followed this tradition, while emphasizing the clinical aspects: epidemiology, diagnosis, prevention, and treatment of intraoperative awareness, with a conference slogan of 'Minding the Mind of Subconscious Self'. Although anaesthesiology has devoted tremendous efforts to studies of anaesthetic pharmacology and the mechanisms of anaesthetic-induced unconsciousness, † Chair of the 9th International Symposium on Memory and Awareness in Anesthesia (MAA9); Co-Editor, Special Issue on Memory and Awareness in Anaesthesia. ‡ Co-Editor, Special Issue on Memory and Awareness in Anaesthesia.

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