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- Publisher Website: 10.1111/anae.13781
- Scopus: eid_2-s2.0-85009892716
- PMID: 28094434
- WOS: WOS:000398061000009
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Article: The effect of remifentanil on propofol requirements to achieve loss of response to command vs. loss of response to pain
Title | The effect of remifentanil on propofol requirements to achieve loss of response to command vs. loss of response to pain |
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Authors | |
Keywords | Bispectral index (BIS) Pain Propofol Remifentanil Total intravenous anaesthesia (TIVA) |
Issue Date | 2017 |
Publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 |
Citation | Anaesthesia, 2017, v. 72 n. 4, p. 479-487 How to Cite? |
Abstract | When providing total intravenous anaesthesia, careful selection of end‐points is required in titrating dose to effect during induction. Although propofol and remifentanil have predominantly different pharmacodynamic effects, they are seen to interact in achieving loss of consciousness and analgesia. To highlight these differences, we performed a double‐blind, randomised controlled trial, comparing one group of patients receiving propofol alone (n = 42) with another group receiving remifentanil plus propofol (n = 46) as a target‐controlled infusion of remifentanil (Minto; 3 ng.ml−1). Propofol was also titrated using a target‐controlled infusion (Marsh effect model) to produce loss of response to tactile and vocal stimuli, and subsequently to loss of response to pain. The effect‐site concentration of propofol at which 50% of patients lost tactile/verbal response was 2.9 μg.ml−1 in the propofol only group and 2.4 μg.ml−1 in the remifentanil with propofol group. In contrast, loss of pain response occurred at 4.4 μg.ml−1 in the propofol group, and 2.7 μg.ml−1 in the remifentanil with propofol group, with correspondingly lower bispectral index values. Judicious use of analgesia in total intravenous anaesthesia can have a propofol‐sparing effect and potentially minimise the suppression of brain electrical activity. |
Persistent Identifier | http://hdl.handle.net/10722/240902 |
ISSN | 2023 Impact Factor: 7.5 2023 SCImago Journal Rankings: 2.400 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Scott, HB | - |
dc.contributor.author | Choi, SW | - |
dc.contributor.author | Wong, GTC | - |
dc.contributor.author | Irwin, MG | - |
dc.date.accessioned | 2017-05-22T09:19:10Z | - |
dc.date.available | 2017-05-22T09:19:10Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Anaesthesia, 2017, v. 72 n. 4, p. 479-487 | - |
dc.identifier.issn | 0003-2409 | - |
dc.identifier.uri | http://hdl.handle.net/10722/240902 | - |
dc.description.abstract | When providing total intravenous anaesthesia, careful selection of end‐points is required in titrating dose to effect during induction. Although propofol and remifentanil have predominantly different pharmacodynamic effects, they are seen to interact in achieving loss of consciousness and analgesia. To highlight these differences, we performed a double‐blind, randomised controlled trial, comparing one group of patients receiving propofol alone (n = 42) with another group receiving remifentanil plus propofol (n = 46) as a target‐controlled infusion of remifentanil (Minto; 3 ng.ml−1). Propofol was also titrated using a target‐controlled infusion (Marsh effect model) to produce loss of response to tactile and vocal stimuli, and subsequently to loss of response to pain. The effect‐site concentration of propofol at which 50% of patients lost tactile/verbal response was 2.9 μg.ml−1 in the propofol only group and 2.4 μg.ml−1 in the remifentanil with propofol group. In contrast, loss of pain response occurred at 4.4 μg.ml−1 in the propofol group, and 2.7 μg.ml−1 in the remifentanil with propofol group, with correspondingly lower bispectral index values. Judicious use of analgesia in total intravenous anaesthesia can have a propofol‐sparing effect and potentially minimise the suppression of brain electrical activity. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 | - |
dc.relation.ispartof | Anaesthesia | - |
dc.subject | Bispectral index (BIS) | - |
dc.subject | Pain | - |
dc.subject | Propofol | - |
dc.subject | Remifentanil | - |
dc.subject | Total intravenous anaesthesia (TIVA) | - |
dc.title | The effect of remifentanil on propofol requirements to achieve loss of response to command vs. loss of response to pain | - |
dc.type | Article | - |
dc.identifier.email | Scott, HB: hbscott@hku.hk | - |
dc.identifier.email | Choi, SW: htswchoi@hku.hk | - |
dc.identifier.email | Wong, GTC: gordon@hku.hk | - |
dc.identifier.email | Irwin, MG: mgirwin@hku.hk | - |
dc.identifier.authority | Scott, HB=rp01692 | - |
dc.identifier.authority | Choi, SW=rp02552 | - |
dc.identifier.authority | Wong, GTC=rp00523 | - |
dc.identifier.authority | Irwin, MG=rp00390 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1111/anae.13781 | - |
dc.identifier.pmid | 28094434 | - |
dc.identifier.scopus | eid_2-s2.0-85009892716 | - |
dc.identifier.hkuros | 272143 | - |
dc.identifier.volume | 72 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 479 | - |
dc.identifier.epage | 487 | - |
dc.identifier.isi | WOS:000398061000009 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0003-2409 | - |