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Potency of propofol for inducing loss of consciousness in end-stage kidney disease patients
- Source :
- PLoS ONE, PLoS ONE, Vol 16, Iss 8, p e0254520 (2021)
- Publication Year :
- 2021
- Publisher :
- Public Library of Science, 2021.
-
Abstract
- It can be difficult for anesthesiologists to determine the optimal dose of propofol for end-stage kidney disease (ESKD) patients due to changes in drug disposition. The purpose of this study was to evaluate the potency of propofol for inducing loss of consciousness in ESKD patients. Patients with normal kidney function (Control group, n = 15), those with ESKD (ESKD group, n = 15), and those with ESKD undergoing cervical epidural anesthesia (ESKD-CEB group, n = 15) were administered propofol by target-controlled infusion (TCI) using the Schneider model. The effect-site concentration (Ce) of propofol started at 0.5 μg/ml and increased in increments of 0.5 μg/ml until the patient did not respond to verbal commands. The relationship between the probability (P) of loss of consciousness and the Ce of propofol was analyzed in each group using logistic regression. The Ce values of propofol at the time of loss of consciousness were 4.3 ± 0.9, 3.7 ± 0.9, and 3.3 ± 1.0 μg/ml for the Control, ESKD, and ESKD-CEB* groups, respectively (*significant difference vs. control, P < 0.05). The estimated Ce50 values for lost ability to respond to verbal command were 4.56, 3.75, and 3.21 μg/ml for the Control, ESKD, and ESKD-CEB groups, respectively. In conclusion, when inducing anesthesia in ESKD patients, we recommend using an initial dose similar to that of patients with normal kidney function, or rather starting with a lower dose.
- Subjects :
- Male
Unconsciousness
Epidural Block
Anesthesiology
Chronic Kidney Disease
Medicine and Health Sciences
Medicine
Anesthesia
Propofol
Geriatric Nephrology
Multidisciplinary
Pharmaceutics
Drugs
Middle Aged
Nephrology
Anesthesia, Intravenous
Female
Anatomy
Anesthetics, Intravenous
medicine.drug
Research Article
Anesthesia, Epidural
Consciousness
Initial dose
Science
Cognitive Neuroscience
Renal function
Surgical and Invasive Medical Procedures
Drug Therapy
Renal Diseases
Potency
Pain Management
Humans
End-stage kidney disease
Anesthetics
Aged
Pharmacology
Dose-Response Relationship, Drug
business.industry
Geriatric nephrology
Significant difference
Biology and Life Sciences
Kidneys
Renal System
medicine.disease
Logistic Models
Geriatrics
Cognitive Science
Kidney Failure, Chronic
Local and Regional Anesthesia
business
Kidney disease
Neuroscience
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....2668096efd53923ea42941d2630b1c34