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PubMed2006

Bronchial mucus transport velocity in patients receiving anaesthesia with propofol and morphine or propofol and remifentanil.

In vitro morphine does not reduce cilia beat frequency, a key factor determining bronchial mucus transport velocity. There are no reports about the effect of remifentanil on bronchial mucus transport. We compared the bronchial mucus transport velocity in patients having total intravenous anaesthesia with either propofol and morphine, or propofol and remifentanil. Twenty patients scheduled for elective surgery were randomly allocated to the two groups. Fifteen minutes after insertion of the laryngeal mask airway, bronchial mucus transport velocity was assessed by fibreoptic observation of the movement of methylene blue dye applied to the right main bronchus. Compared with morphine, bronchial mucus transport velocity was significantly reduced in patients receiving remifentanil (morphine mean (SD) 9.2 (5.8) vs remifentanil 4.2 (3.0) mm.min(-1), p = 0.028). Anaesthesia with remifentanil may lead to significantly impaired bronchociliary clearance in comparison to morphine. This could have clinical implications, in particular in patients at risk.

Adult↗

PubMed2000

Abuse liability of the anesthetic propofol: self-administration of propofol in rats under fixed-ratio schedules of drug delivery.

RATIONALE: Previous reports suggest that propofol (PPF) may have abuse potential in humans. Hence, we hypothesized that PPF could reinforce self-administration behavior in other species. Positive reinforcing effects of PPF could be interpreted as an index of abuse liability. OBJECTIVE: Acquisition and maintenance of i.v. PPF self-administration were examined in 12 rats. METHODS: Six rats were initially given access to methohexital (MHX, 2.0 mg/kg per infusion) under a fixed ratio (FR) 1 schedule, while the other six were initially given access to PPF (1.7 mg/kg per infusion). Once stable responding was established, various doses of PPF (0.56, 1.0, and 1.7 mg/kg per infusion) and vehicle (Intralipid 20%) were made available. RESULTS: The number of PPF infusions per session was an inverse function of dose, with 0.56 mg/kg and 1.0 mg/kg per infusion maintaining significantly more infusions per session than vehicle in most rats under the FR 1 schedule. For some rats, the number of vehicle infusions per session was equal to or greater than the number of PPF infusions. Increasing the response requirement to FR 5 decreased the number of vehicle infusions per session in these rats, while PPF maintained a higher number of infusions than vehicle under this FR value in six of seven rats. CONCLUSION: PPF served as a reinforcer in rats under FR schedules of i.v. drug delivery, adding to the extant evidence that it has abuse potential.

Anesthetics, Intravenous↗

PubMed1991

Comparison of arterial and arterialized venous concentrations of propofol during infusion of propofol.

Seven patients received a series of low-dose propofol infusions designed to produce three successive pseudo-steady states of arterial blood concentration: 0.06, 0.17 and 0.43 micrograms ml-1. Arterial and arterialized venous blood samples were obtained simultaneously at the end of each infusion. The results indicate that 95% of the arterialized venous concentrations may be expected to lie within 1 +/- 43% of the corresponding arterial concentration, or -5 +/- 35% if one set of measurements with poor agreement between duplicate aliquots is omitted.

Arteries↗

PubMed2000

Comparison of intubating conditions following propofol and succinylcholine with propofol and remifentanil 2 micrograms kg-1 or 4 micrograms kg-1.

We evaluated the intubating conditions, haemodynamic responses and duration of apnoea in 60 healthy adult patients after propofol 2 mg kg-1 combined with either a bolus of remifentanil 2 micrograms kg-1 or 4 micrograms kg-1, or succinylcholine 1 mg kg-1. Patients intubated following remifentanil showed dose-dependent intubating conditions, similar at 4 micrograms kg-1 to the conditions produced with succinylcholine. Post-induction mean arterial pressure decreased from baseline values by 21% (P < 0.0001), 28% (P < 0.0001) and 8% (P > 0.05) in the remifentanil 2 micrograms kg-1, remifentanil 4 micrograms kg-1 and succinylcholine 1 mg kg-1 groups, respectively. The mean (SD) duration of apnoea following induction was 9.3 (2.6) min and 12.8 (2.9) min in the remifentanil 2 micrograms kg-1 and 4 micrograms kg-1 groups, and 6.0 (0.9) min in the succinylcholine group (P < 0.001 between groups).

Adolescent↗

PubMed2007

A comparison of intubating conditions in children following induction of anaesthesia with propofol and suxamethonium or propofol and remifentanil.

Sixty ASA 1 and 2 children aged between 2 and 16 years who required tracheal intubation as part of anaesthesia for elective surgery were studied. We evaluated intubating conditions, haemodynamic responses and duration of apnoea following propofol 4 mg.kg-1 combined with either remifentanil 1.25 microg.kg-1 (group R), or suxamethonium 1 mg.kg-1 (group S). Tracheal intubation was graded as excellent, good or poor according to ease of laryngoscopy, vocal cord position, coughing, and jaw relaxation and limb movement. Thirty of group S and 28 of group R children were successfully intubated on the first attempt. Overall, intubation conditions were excellent or good in 26/30 (87%) patients in group S and 20/30 (67%) in group R (p<0.05). Mean apnoea time was 190 s in group S, and 362 s in group R (p<0.001). Heart rate increased in response to suxamethonium (p<0.01) and both systolic and diastolic blood pressure decreased in the remifentanil group (p<0.01).

Adolescent↗

PubMed1997

[Anesthesia induction for laryngeal mask insertion--comparison of propofol with midazolam and propofol with thiopental].

We compared the patient's response to laryngeal mask (LM) insertion and hemodynamics among three anesthesia induction methods; P group using 2.5 mg.kg-1 propofol with 0.2 microgram.kg-1 fentanyl, M group using 0.2 mg.kg-1 midazolam with 0.2 microgram. kg-1 fentanyl, B group using 5 mg.kg-1 thiopental with 0.2 microgram.kg-1 fentanyl. Each 30 patients, 35 to 65 years, for elective mastectomy were entered in three groups. Preanesthetic medication was i.m. injection of 0.5 mg atropine and 5 mg midazolam 30 min before the induction. Anesthesia was induced with intravenous injection of each dose of P, M or B in 20 sec followed by fentanyl. When verbal response disappeared, a laryngeal mask was inserted. The number of patients with difficult insertion or showing body movement or gagging were larger in the order of M group > B group > P group. Blood pressure and heart rate in the P group were significantly lower than those in the other two groups. It was concluded that P allowed the most smooth insertion of LM among the three groups, but it also induced hypotension and bradycardia.

Adult↗

PubMed1995