Comparison of the clinical performance of the modified Marsh model for propofol between underweight and normal-weight patients with Crohn's disease / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 606-611, 2017.
Artigo
em Inglês
| WPRIM
| ID: wpr-95776
ABSTRACT
BACKGROUND:
The aim of this retrospective study was to compare the clinical performance of the modified Marsh model for propofol between underweight and normal-weight patients with Crohn's disease.METHODS:
The medical records of 50 patients who underwent elective surgery for Crohn's disease were reviewed retrospectively. Propofol and remifentanil were administered using target effect-site concentration (Ce)-controlled infusion with the modified Marsh and Minto models. Target Ce values of propofol were adjusted within a range of 2.5–3 µg/ml to maintain a bispectral index (BIS) value of less than 60 during anesthesia maintenance. Dosages of anesthetic agents administered during surgery were compared between underweight and normal-weight patients. The infusion profiles of patients were applied as inputs to calculate the Ce values in the Schnider model.RESULTS:
The total midazolam and remifentanil dosages required for underweight patients were higher than those required for normal-weight patients to maintain BIS values at less than 60 within a target propofol Ce range of 2.5–3 µg/ml. Simulation results suggested that the Schnider model may be an appropriate pharmacokinetic model for target-controlled infusion in underweight patients, as the clearance was consistently higher in the Schnider model than the modified Marsh model, particularly in underweight patients.CONCLUSIONS:
The modified Marsh model might cause inadvertent propofol underdosing in underweight patients. Future studies are necessary to compare the predictive performance of the modified Marsh and Schnider pharmacokinetic models in underweight patients.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Magreza
/
Midazolam
/
Farmacocinética
/
Doença de Crohn
/
Propofol
/
Prontuários Médicos
/
Estudos Retrospectivos
/
Áreas Alagadas
/
Anestesia
/
Anestésicos
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Korean Journal of Anesthesiology
Ano de publicação:
2017
Tipo de documento:
Artigo
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