Searchable BIS Bibliography Database
Searchable BIS Bibliography Database
[Turn Help On]
Framed Question: Bispectral Index Evidence
ID: 204074     
ISSN #: 1526-7598 (Electronic)
Publication Type: Clinical Trial
Title: The influence of age on the dynamic relationship between end-tidal sevoflurane concentrations and bispectral index.
Authors: Cortinez LI
Troconiz IF
Fuentes R
Gambus P
Hsu YW
Altermatt F
Munoz HR
Source: Anesth Analg. 2008 Nov;107(5):1566-72.
Acronym:
MeSH: Adolescent
Adult
Aged
Aging/drug effects/*physiology
Anesthetics, Inhalation/*pharmacology
Child
Child, Preschool
Drug Hypersensitivity
Electroencephalography/drug effects
Humans
Methyl Ethers/*pharmacology
Middle Aged
*Tidal Volume/drug effects
Abstract: BACKGROUND: Age is an important determinant of the pharmacokinetic profile of inhaled anesthetics. The influence of age on the dynamic profile of sevoflurane's effect has not been well described. We performed this study to characterize the influence of age and other covariates on the dynamic relationship between sevoflurane end-tidal concentration (C(ET)) and its effect measured by bispectral index (BIS). METHODS: Fifty patients, aged 3-71 yr, scheduled for minor surgery were prospectively studied. The BIS and sevoflurane C(ET) were continuously measured during the study period. During maintenance of anesthesia and after stable BIS values of 60-65 were obtained, the inspired concentration of sevoflurane was increased to 5 vol % for 5 min or until BIS <40 and then decreased. The dynamic relationship between sevoflurane C(ET) and its effect as measured by BIS during this transition period were modeled with an inhibitory E(max) model using a population pharmacokinetic-pharmacodynamic approach with NONMEM V. A predictive check method was used to validate the final model. RESULTS: The sensitivity to sevoflurane's effect as measured by BIS expressed in the C(50) [steady-state C(ET) eliciting half of maximum response (I(max))] increased with age. The speed of change of sevoflurane's effect, expressed as the effect-site equilibration half-life (t(1/2) k(e0)), increased at older ages. The predictive check analysis confirmed the adequacy of the model. CONCLUSIONS: Age significantly affects the dynamic relationship between sevoflurane C(ET) and its effect measured with BIS.
Country: United States
Language: eng
Institution: Departmento de Anestesiología, Hospital Clínico U.C., Marcoleta 367, Santiago, Chile. licorti@med.puc.cl
[Show Notes]

Back To Abstract List

Next Abstract

Print Abstract



Reg. Part: 085-1007 1.04