Sufentanil en anesthésie balancée: intérêt de prédire les concentrations pour optimiser les doses

Billard, V.; Deleuze, Arnaud; Penot, Christine; Lohberger, C.; Kolb, Florian P.; Elias, D.

doi:10.1016/s0750-7658(99)90279-4

Annales Françaises d'Anesthésie et de Réanimation

1999

DOI: 10.1016/s0750-7658(99)90279-4

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Sufentanil en anesthésie balancée: intérêt de prédire les concentrations pour optimiser les doses

V. Billard

Arnaud Deleuze

Christine Penot

et al.

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2007

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Propofol and Remifentanil Effect-site Concentrations Estimated by Pharmacokinetic Simulation and Bispectral Index Monitoring During Craniotomy With Intraoperative Awakening for Brain Tumor Resection

Lobo

2007

Journal of Neurosurgical Anesthesiology

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Different anesthetic techniques have been suggested for craniotomy with intraoperative awakening. We describe an asleep-awake-asleep technique with propofol and remifentanil infusions, with pharmacokinetic simulation to predict the effect-site concentrations and to modulate the infusion rates of both drugs, and bispectral index (BIS) monitoring. Five critical moments were defined: first loss of consciousness (LOC 1 ), first recovery of consciousness (ROC 1 ), final of neurologic testing (NT), second loss of consciousness (LOC 2 ), and second recovery of consciousness (ROC 2 ). At LOC 1 , predicted effect-site concentrations of propofol and remifentanil were, respectively, 3.6±1.2 μg/mL and 2.4±0.4 ηg/mL. At ROC 1 , predicted effect-site concentrations of propofol and remifentanil were, respectively, 2.1±0.3 μg/mL and 1.8±0.3 ηg/mL. At NT, predicted effect-site concentrations of propofol and remifentanil were, respectively, 0.9±0.3 μg/mL and 1.8±0.2 ηg/mL. At LOC 2 , predicted effect-site concentrations of propofol and remifentanil were, respectively, 2.1±0.2 μg/mL and 2.5±0.2 ηg/mL. At ROC 2 , predicted effect-site concentrations of propofol and remifentanil were, respectively, 1.2±0.5 μg/mL and 1.4±0.2 ηg/mL (data are mean±SE). A significative correlation was found between BIS and predicted effect-site concentrations of propofol (r 2 =0.547, P<0.001) and remifentanil (r 2 =0.533, P<0.001). Multiple regression analysis between BIS and propofol and remifentanil predicted effect-site concentrations at the different critical steps of the procedure was done and found also significative (r 2 =0.7341, P<0.001).

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Propofol and Remifentanil Effect-site Concentrations Estimated by Pharmacokinetic Simulation and Bispectral Index Monitoring During Craniotomy With Intraoperative Awakening for Brain Tumor Resection

Lobo

2007

Journal of Neurosurgical Anesthesiology

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Sufentanil en anesthésie balancée: intérêt de prédire les concentrations pour optimiser les doses

Cited by 1 publication

References 7 publications

Propofol and Remifentanil Effect-site Concentrations Estimated by Pharmacokinetic Simulation and Bispectral Index Monitoring During Craniotomy With Intraoperative Awakening for Brain Tumor Resection

Propofol and Remifentanil Effect-site Concentrations Estimated by Pharmacokinetic Simulation and Bispectral Index Monitoring During Craniotomy With Intraoperative Awakening for Brain Tumor Resection

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