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Propofol and remifentanil effect‐site concentrations estimated by pharmacokinetic simulation and bispectral index monitoring during craniotomy with intraoperative awakening for brain tumor resection.

dc.contributor.authorLOBO, F.
dc.contributor.authorBEIRAS, A.
dc.date.accessioned2011-07-06T08:58:07Z
dc.date.available2011-07-06T08:58:07Z
dc.date.issued2007-07
dc.description.abstractJ Neurosurg Anesthesiol. 2007 Jul;19(3):183-9. Propofol and remifentanil effect-site concentrations estimated by pharmacokinetic simulation and bispectral index monitoring during craniotomy with intraoperative awakening for brain tumor resection. Lobo F, Beiras A. SourceAnesthesiology Department, Hospital Geral de Santo António, Porto, Portugal. xlanesth@mail.telepac.pt Abstract Different anesthetic techniques have been suggested for craniotomy with intraoperative awakening. We describe an asleep-awake-asleep technique with propofol and remifentanil infusions, with pharmacokinetic simulation to predict the effect-site concentrations and to modulate the infusion rates of both drugs, and bispectral index (BIS) monitoring. Five critical moments were defined: first loss of consciousness (LOC1), first recovery of consciousness (ROC1), final of neurologic testing (NT), second loss of consciousness (LOC2), and second recovery of consciousness (ROC2). At LOC1, predicted effect-site concentrations of propofol and remifentanil were, respectively, 3.6+/-1.2 microg/mL and 2.4+/-0.4 etag/mL. At ROC1, predicted effect-site concentrations of propofol and remifentanil were, respectively, 2.1+/-0.3 microg/mL and 1.8+/-0.3 etag/mL. At NT, predicted effect-site concentrations of propofol and remifentanil were, respectively, 0.9+/-0.3 microg/mL and 1.8+/-0.2 etag/mL. At LOC2, predicted effect-site concentrations of propofol and remifentanil were, respectively, 2.1+/-0.2 microg/mL and 2.5+/-0.2 etag/mL. At ROC2, predicted effect-site concentrations of propofol and remifentanil were, respectively, 1.2+/-0.5 microg/mL and 1.4+/-0.2 etag/mL (data are mean+/-SE). A significative correlation was found between BIS and predicted effect-site concentrations of propofol (r=0.547, P<0.001) and remifentanil (r=0.533, P<0.001). Multiple regression analysis between BIS and propofol and remifentanil predicted effect-site concentrations at the different critical steps of the procedure was done and found also significative (r=0.7341, P<0.001).por
dc.identifier.issn0898-4921
dc.identifier.urihttp://hdl.handle.net/10400.16/721
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherLippincott, Williams & Wilkinspor
dc.relation.publisherversionhttp://journals.lww.com/jnsa/Abstract/2007/07000/Propofol_and_Remifentanil_Effect_site.7.aspxpor
dc.titlePropofol and remifentanil effect‐site concentrations estimated by pharmacokinetic simulation and bispectral index monitoring during craniotomy with intraoperative awakening for brain tumor resection.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleJournal of Neurosurgical Anesthesiologypor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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