Female Patients Require a Higher Propofol Infusion Rate for Sedation

Overview

Journal Anesth Prog

Specialties Anesthesiology
Dentistry

Date 2016 Jun 9

PMID 27269663

Citations 6

Authors

Shigeru Maeda

Yumiko Tomoyasu

Hitoshi Higuchi

Yuka Honda

Minako Ishii-Maruhama

Takuya Miyawaki

Affiliations

Soon will be listed here.

Abstract

Sedation may minimize physiologic and behavioral stress responses. In our facility, the infusion rate of propofol is adjusted according to the bispectral index (BIS) in all cases of implant-related surgery; multivariate analysis of retrospective data enabled us to extract independent factors that affect the dose of propofol in sedation that are considered useful indicators for achieving adequate sedation. The study population comprised all patients undergoing implant-related surgery under intravenous sedation in Okayama University Hospital from April 2009 to March 2013. The infusion rate of propofol was adjusted to maintain the BIS value at 70-80. The outcome was the average infusion rate of propofol, and potential predictor variables were age, sex, body weight, treatment time, and amount of midazolam. Independent variables that affected the average infusion rate of propofol were extracted with multiple regression analysis. One hundred twenty-five subjects were enrolled. In the multiple regression analysis, female sex was shown to be significantly associated with a higher average infusion rate of propofol. Females may require a higher infusion rate of propofol than males to achieve adequate sedation while undergoing implant-related surgery.

Citing Articles

Efficacy and safety of remimazolam besilate for sedation in outpatients undergoing impacted third molar extraction: a prospective exploratory study.

Oue K, Oda A, Shimizu Y, Takahashi T, Kamio H, Sasaki U BMC Oral Health. 2023; 23(1):774.

PMID: 37865761 PMC: 10589926. DOI: 10.1186/s12903-023-03538-2.

Comparison of the respiratory effects of commonly utilized general anaesthesia regimes in male Sprague-Dawley rats.

Ballok B, Schranc A, Toth I, Somogyi P, Tolnai J, Petak F Front Physiol. 2023; 14:1249127.

PMID: 37791348 PMC: 10544940. DOI: 10.3389/fphys.2023.1249127.

Considerations for Satisfactory Sedation during Dental Implant Surgery.

Ito T, Utsumi N, Baba Y, Matsumura T, Wakita R, Maeda S J Pers Med. 2023; 13(3).

PMID: 36983643 PMC: 10054855. DOI: 10.3390/jpm13030461.

Evaluation of endovenous sedation using BIS monitoring in dentistry. A systematic review.

Perez-Garcia S, Lozano-Carrascal N, Ruiz-Roca J, Lopez-Jornet P, Gargallo-Albiol J Med Oral Patol Oral Cir Bucal. 2020; 25(4):e439-e448.

PMID: 32520922 PMC: 7338067. DOI: 10.4317/medoral.22884.

Comparison of plasma propofol concentration for apnea, response to mechanical ventilation, and airway device between endotracheal tube and supraglottic airway device in Beagles.

Iizuka T, Masui K, Kanazawa H, Nishimura R J Vet Med Sci. 2018; 80(9):1420-1423.

PMID: 30012918 PMC: 6160887. DOI: 10.1292/jvms.17-0468.

References

von Delius S, Salletmaier H, Meining A, Wagenpfeil S, Saur D, Bajbouj M . Bispectral index monitoring of midazolam and propofol sedation during endoscopic retrograde cholangiopancreatography: a randomized clinical trial (the EndoBIS study). Endoscopy. 2012; 44(3):258-64. DOI: 10.1055/s-0031-1291485. View

McKeage K, Perry C . Propofol: a review of its use in intensive care sedation of adults. CNS Drugs. 2003; 17(4):235-72. DOI: 10.2165/00023210-200317040-00003. View

Shafer A, Doze V, Shafer S, White P . Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology. 1988; 69(3):348-56. DOI: 10.1097/00000542-198809000-00011. View

Taguchi T, Fukuda K, Sekine H, Kakizawa T . Intravenous sedation and hemodynamic changes during dental implant surgery. Int J Oral Maxillofac Implants. 2011; 26(6):1303-8. View

Gan T, Glass P, Sigl J, Sebel P, Payne F, Rosow C . Women emerge from general anesthesia with propofol/alfentanil/nitrous oxide faster than men. Anesthesiology. 1999; 90(5):1283-7. DOI: 10.1097/00000542-199905000-00010. View

Sakaguchi M, Higuchi H, Maeda S, Miyawaki T . Dental sedation for patients with intellectual disability: a prospective study of manual control versus Bispectral Index-guided target-controlled infusion of propofol. J Clin Anesth. 2011; 23(8):636-42. DOI: 10.1016/j.jclinane.2011.04.008. View

Ueno D, Sato J, Nejima J, Maruyama K, Kobayashi M, Iketani T . Effects of implant surgery on blood pressure and heart rate during sedation with propofol and midazolam. Int J Oral Maxillofac Implants. 2012; 27(6):1520-6. View

Vuyk J, Oostwouder C, Vletter A, Burm A, Bovill J . Gender differences in the pharmacokinetics of propofol in elderly patients during and after continuous infusion. Br J Anaesth. 2001; 86(2):183-8. DOI: 10.1093/bja/86.2.183. View

Apfelbaum J, Grasela T, HUG Jr C, McLeskey C, Nahrwold M, Roizen M . The initial clinical experience of 1819 physicians in maintaining anesthesia with propofol: characteristics associated with prolonged time to awakening. Anesth Analg. 1993; 77(4 Suppl):S10-4. View

10.

Kodaka M, Suzuki T, Maeyama A, Koyama K, Miyao H . Gender differences between predicted and measured propofol C(P50) for loss of consciousness. J Clin Anesth. 2006; 18(7):486-9. DOI: 10.1016/j.jclinane.2006.08.004. View

11.

Lo Y, Lin T, Fang Y, Wang T, Chen H, Chou C . Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: a randomized controlled trial. PLoS One. 2011; 6(11):e27769. PMC: 3223212. DOI: 10.1371/journal.pone.0027769. View

12.

Gonzalez-Lemonnier S, Bovaira-Forner M, Penarrocha-Diago D, Penarrocha-Diago M . Hemodynamic and ventilatory changes during implant surgery with intravenous conscious sedation. Med Oral Patol Oral Cir Bucal. 2010; 16(4):e541-5. DOI: 10.4317/medoral.16.e541. View

13.

Fanti L, Agostoni M, Massimo A, Gemma M, Marco G, Gambino G . Remifentanil vs. meperidine for patient-controlled analgesia during colonoscopy: a randomized double-blind trial. Am J Gastroenterol. 2009; 104(5):1119-24. DOI: 10.1038/ajg.2009.53. View

14.

Cheung C, Ng K, Liu J, Yuen M, Ho M, Irwin M . Analgesic and sedative effects of intranasal dexmedetomidine in third molar surgery under local anaesthesia. Br J Anaesth. 2011; 107(3):430-7. DOI: 10.1093/bja/aer164. View

15.

Choong E, Loryan I, Lindqvist M, Nordling A, El Bouazzaoui S, van Schaik R . Sex difference in formation of propofol metabolites: a replication study. Basic Clin Pharmacol Toxicol. 2013; 113(2):126-31. DOI: 10.1111/bcpt.12070. View

16.

Absalom A, Mani V, De Smet T, Struys M . Pharmacokinetic models for propofol--defining and illuminating the devil in the detail. Br J Anaesth. 2009; 103(1):26-37. DOI: 10.1093/bja/aep143. View

17.

Sasaki T, Tanabe S, Azuma M, Sato A, Naruke A, Ishido K . Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomized prospective phase II clinical trial. Endoscopy. 2012; 44(6):584-9. DOI: 10.1055/s-0032-1306776. View

18.

Schnider T, Minto C, Gambus P, Andresen C, Goodale D, Shafer S . The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology. 1998; 88(5):1170-82. DOI: 10.1097/00000542-199805000-00006. View

19.

Ward D, Norton J, Guivarch P, Litman R, Bailey P . Pharmacodynamics and pharmacokinetics of propofol in a medium-chain triglyceride emulsion. Anesthesiology. 2002; 97(6):1401-8. DOI: 10.1097/00000542-200212000-00011. View