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[Simplified method to maintain propofol blood concentration in an approximately constant level associated to nitrous

Pedro Thadeu Galvão Vianna1, Elizabeth Pricoli Vilela, Francisco Carlos Obata Cordon

  • 1Departamento de Anestesiologia, Universidade Estadual de São Paulo, Brazil. ptgv@uol.com.br

Revista Brasileira De Anestesiologia
|May 30, 2009
PubMed

Insights

Marsh pharmacokinetic parameters for propofol infusion in children resulted in a lower error rate for achieving target concentrations. This method also required less propofol for similar clinical outcomes, making it preferable for pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pharmacokinetics
  • Pediatric Medicine

Context:

  • Target-controlled infusion (TCI) of propofol aims for stable blood concentrations.
  • Optimizing TCI requires accurate pharmacokinetic models.
  • Pediatric anesthesia presents unique challenges in drug dosing.

Purpose:

  • To compare the clinical and laboratory performance of propofol infusion in children using two pharmacokinetic models: Shorts and Marsh.
  • To evaluate the accuracy of achieving a target propofol concentration of 4 microg.kg-1.

Summary:

  • Forty-one pediatric patients (4-12 years) received propofol anesthesia using either Shorts (Group S) or Marsh (Group M) parameters.
  • Blood propofol concentrations were measured at 20, 40, and 60 minutes.
  • Marsh parameters demonstrated a statistically significant lower error rate (EPAM) at 60 minutes and required less propofol for comparable clinical results.

Impact:

  • Marsh pharmacokinetic parameters are more accurate for TCI of propofol in pediatric patients aged 4-12 years.
  • This approach can lead to more efficient anesthetic management and potentially reduced drug administration.
  • Recommends Marsh parameters as the preferred method for this patient population.
Abstract

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