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Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant

BACKGROUND AND AIMS: Insertion of laryngeal mask airway (LMA) requires adequate depth of anaesthesia, which provides jaw relaxation and suppression of upper airway reflexes. Propofol can provide these conditions especially when combined with narcotics. This study had been designed to find out the ef...

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Autores principales: Gopinath, MV, Ravishankar, M, Nag, Kusha, Kumar, VR Hemanth, Velraj, J, Parthasarathy, S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445151/
https://www.ncbi.nlm.nih.gov/pubmed/26019354
http://dx.doi.org/10.4103/0019-5049.156874
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author Gopinath, MV
Ravishankar, M
Nag, Kusha
Kumar, VR Hemanth
Velraj, J
Parthasarathy, S
author_facet Gopinath, MV
Ravishankar, M
Nag, Kusha
Kumar, VR Hemanth
Velraj, J
Parthasarathy, S
author_sort Gopinath, MV
collection PubMed
description BACKGROUND AND AIMS: Insertion of laryngeal mask airway (LMA) requires adequate depth of anaesthesia, which provides jaw relaxation and suppression of upper airway reflexes. Propofol can provide these conditions especially when combined with narcotics. This study had been designed to find out the effect-site concentration (EC(50)) of propofol using target controlled infusion (TCI) when fentanyl or morphine is added as an adjuvant. METHODS: Patients satisfying inclusion criteria were divided into fentanyl and morphine groups. Intravenous glycopyrrolate 0.2 mg was given 15 min before induction. Patients were given either intravenous fentanyl (1 μg/kg) or morphine (0.1 mg/kg) before propofol infusion depending on the group. Patients in either groups were induced by continuous infusion of propofol at an EC of 6 μg/mL by TCI with Schneider pharmacokinetic model. The LMA supreme of appropriate size was inserted 1 min after achieving target concentration. Patient movement at LMA insertion or within 1 min of insertion was classified as failure. For subsequent patients, the target EC was increased/decreased depending on previous patients' response. Dixons up and down method was used to determine the EC(50). The EC(50) is defined as the mean of crossover midpoints in each pair of failure to success. RESULTS: The EC(50) of propofol in the fentanyl group for LMA insertion was 5.95 ± 0.6 μg/ml and morphine group was 5.75 ± 0.8 μg/ml. No significant difference in insertion conditions was noticed between the two groups (P = 0.3). CONCLUSION: We conclude that there was no significant difference in propofol EC(50) for insertion of LMA and insertion conditions were similar when fentanyl or morphine was used as an adjuvant drug.
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spelling pubmed-44451512015-05-27 Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant Gopinath, MV Ravishankar, M Nag, Kusha Kumar, VR Hemanth Velraj, J Parthasarathy, S Indian J Anaesth Clinical Investigation BACKGROUND AND AIMS: Insertion of laryngeal mask airway (LMA) requires adequate depth of anaesthesia, which provides jaw relaxation and suppression of upper airway reflexes. Propofol can provide these conditions especially when combined with narcotics. This study had been designed to find out the effect-site concentration (EC(50)) of propofol using target controlled infusion (TCI) when fentanyl or morphine is added as an adjuvant. METHODS: Patients satisfying inclusion criteria were divided into fentanyl and morphine groups. Intravenous glycopyrrolate 0.2 mg was given 15 min before induction. Patients were given either intravenous fentanyl (1 μg/kg) or morphine (0.1 mg/kg) before propofol infusion depending on the group. Patients in either groups were induced by continuous infusion of propofol at an EC of 6 μg/mL by TCI with Schneider pharmacokinetic model. The LMA supreme of appropriate size was inserted 1 min after achieving target concentration. Patient movement at LMA insertion or within 1 min of insertion was classified as failure. For subsequent patients, the target EC was increased/decreased depending on previous patients' response. Dixons up and down method was used to determine the EC(50). The EC(50) is defined as the mean of crossover midpoints in each pair of failure to success. RESULTS: The EC(50) of propofol in the fentanyl group for LMA insertion was 5.95 ± 0.6 μg/ml and morphine group was 5.75 ± 0.8 μg/ml. No significant difference in insertion conditions was noticed between the two groups (P = 0.3). CONCLUSION: We conclude that there was no significant difference in propofol EC(50) for insertion of LMA and insertion conditions were similar when fentanyl or morphine was used as an adjuvant drug. Medknow Publications & Media Pvt Ltd 2015-05 /pmc/articles/PMC4445151/ /pubmed/26019354 http://dx.doi.org/10.4103/0019-5049.156874 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Gopinath, MV
Ravishankar, M
Nag, Kusha
Kumar, VR Hemanth
Velraj, J
Parthasarathy, S
Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title_full Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title_fullStr Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title_full_unstemmed Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title_short Estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
title_sort estimation of effect-site concentration of propofol for laryngeal mask airway insertion using fentanyl or morphine as adjuvant
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445151/
https://www.ncbi.nlm.nih.gov/pubmed/26019354
http://dx.doi.org/10.4103/0019-5049.156874
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