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Propofol concentration to induce general anesthesia in children aged 3-11 years with the Kataria effect-site model

Ricardo Fuentes1, Ignacio Cortínez, Mauricio Ibacache

  • 1Department of Anesthesiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Paediatric Anaesthesia
|April 17, 2015
PubMed

Insights

This study identified propofol effect-site concentration targets for inducing anesthesia in children aged 3-11 years using the Kataria pharmacokinetic model. Recommended targets decrease with age, suggesting model adjustments may be needed.

Area of Science:

  • Anesthesiology
  • Pharmacokinetics
  • Pediatric Medicine

Background:

  • The Kataria pharmacokinetic model for propofol was adapted for effect-site target-controlled infusion (TCI).
  • Specific propofol effect-site concentration (Ce) targets for pediatric general anesthesia induction using this model were previously undescribed.

Purpose of the Study:

  • To determine propofol Ce targets associated with 50% (Ce50) and 95% (Ce95) success rates for anesthesia induction.
  • To investigate these targets in children aged 3-11 years.

Main Methods:

  • Forty-two children (3-11 years) were allocated to seven groups with varying propofol Ce targets.
  • Propofol TCI was initiated after fentanyl administration.
  • Success was defined by loss of eyelash reflex and Bispectral Index < 50 within 45 seconds of reaching the target Ce.
  • Logistic regression analyzed Ce50 and Ce95.

Main Results:

  • Twenty-eight children achieved a successful response.
  • Significant decreases in mean arterial blood pressure and heart rate were observed.
  • Propofol Ce and age were significant factors in the logistic regression model.
  • Calculated propofol Ce50 was 3.8 μg·ml⁻¹ and Ce95 was 6.1 μg·ml⁻¹.

Conclusions:

  • The study provides propofol Ce targets for the Kataria effect-site model in pediatric anesthesia (3-11 years).
  • Progressively lower targets are recommended with increasing age, potentially indicating pharmacokinetic model misspecifications.
Abstract

Keywords:
Propofolchildrenpharmacokineticstarget-controlled infusiontotal intravenous anesthesia

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