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The relationship between the effect-site concentration of propofol and sedation scale in children: a pharmacodynamic

Young-Eun Jang1, Sang-Hwan Ji1, Ji-Hyun Lee1

  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea, #101 Daehak-no, Jongno-gu, 03080, Seoul, Republic of Korea.

BMC Anesthesiology
|September 10, 2021
PubMed

Insights

This study examined propofol

Area of Science:

  • Pharmacology
  • Anesthesiology
  • Pediatric Medicine

Background:

  • Continuous infusion of propofol is used for pediatric sedation.
  • The relationship between propofol effect-site concentration (Ce) and sedation scales is not well-defined.
  • Population pharmacodynamic modeling can elucidate this relationship.

Purpose of the Study:

  • To investigate the relationship between propofol's effect-site concentration (Ce) and the University of Michigan Sedation Scale (UMSS) score in children.
  • To establish a quantitative model for propofol-induced sedation in pediatric patients.
  • To provide data for optimizing propofol dosing for sedation in children.

Main Methods:

  • Thirty pediatric patients (3-6 years) undergoing surgery were enrolled.
  • Propofol Ce was increased stepwise during anesthesia induction, with UMSS scores recorded every 20 seconds.
  • Logistic regression with nonlinear mixed-effect modeling was used to analyze the pharmacodynamic relationship.

Main Results:

  • The estimated Ce50 for UMSS scores of 1, 2, 3, and 4 were 1.84, 2.64, 3.98, and 4.78 μg/mL, respectively.
  • The slope steepness for the Ce versus sedative response was 5.76.
  • These results provide quantitative parameters for propofol's sedative effects.

Conclusions:

  • The pharmacodynamic relationship between propofol Ce and UMSS score in children was quantified.
  • This finding can aid in predicting pediatric sedation scores based on target propofol Ce.
  • The study contributes to the safe and effective use of propofol for pediatric sedation.
Abstract

Keywords:
AnesthesiaAnestheticsPharmacodynamicsPharmacokineticsSedation

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