Predictive performance of 'Servin's formula' during BIS-guided propofol-remifentanil target-controlled infusion in morbidly obese patients.
Background: The aim of this study was to assess the predictive performance of 'Servin's formula' for bispectral index (BIS)-guided propofol-remifentanil target-controlled infusion (TCI) in morbidly obese patients.Methods: Twenty patients (ASA physical status II-III, age 32-64 yr) undergoing bilio-in...
| Publicado en: | BJA: The British Journal of Anaesthesia Vol. 98; no. 1; pp. 66 - 76 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Jan2007
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104745415&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104745415 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00070912 1FZ jtl: BJA: The British Journal of Anaesthesia issn: 00070912 maglogo: N pubinfo: dt: Jan2007 vid: 98 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104745415 104745415 NLM17132644 2011103393 NLM17132644 104745415 ppf: 66 ppct: 10 formats: tig: atl: Predictive performance of 'Servin's formula' during BIS-guided propofol-remifentanil target-controlled infusion in morbidly obese patients. aug: au: Albertin, A Poli, D La Colla, L Gonfalini, M Turi, S Pasculli, N La Colla, G Bergonzi, P C Dedola, E Fermo, I affil: Department of Anaesthesiology--IRCCS San Raffaele, Milan, Italy. albertin.andrea@hsr.it sug: subj: Anesthetics, Intravenous Administration and Dosage Drug Delivery Systems Obesity, Morbid Blood Piperidines Administration and Dosage Propofol Administration and Dosage Adult Analgesics, Opioid Administration and Dosage Anesthetics, Intravenous Blood Body Weight Computer Simulation Electroencephalography Female Gastric Bypass Human Infusions, Intravenous Male Middle Age Obesity, Morbid Surgery Propofol Blood Prospective Studies Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: The aim of this study was to assess the predictive performance of 'Servin's formula' for bispectral index (BIS)-guided propofol-remifentanil target-controlled infusion (TCI) in morbidly obese patients.Methods: Twenty patients (ASA physical status II-III, age 32-64 yr) undergoing bilio-intestinal bypass surgery, were recruited. Anaesthesia was induced by using a TCI of propofol with an initial target plasma concentration of 6 microg ml(-1), then adapted to maintain stable BIS values ranging between 40 and 50. A TCI of remifentanil was added to achieve pain control and haemodynamic stability. For propofol, weight was corrected as suggested by Servin and colleagues. With ideal body weight (IBW) corrected according to formula suggested by Lemmens and colleagues. For remifentanil, weight was corrected according to IBW. Arterial blood samples for the determination of blood propofol concentrations were collected at different surgical times. The predictive performance of propofol TCI was evaluated by examining performance accuracy.Results: Median prediction error and median absolute prediction error were -32.6% (range -53.4%; -2.5%) and 33.1% (10.8%; 53.4%), respectively. Wobble median value was 5.9% (2.5%; 25.2%) while divergence median value was -1.5% h(-1) (-7.7; 33.8% h(-1)).Conclusion: Significant bias between predicted and measured plasma propofol concentrations was found while the low wobble values suggest that propofol TCI system is able to maintain stable drug concentrations over time. As already suggested before, a computer simulation confirmed that the TCI system performance could be significantly improved when total body weight is used. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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