Rate-dependent induction phenomena with propofol: implications for the relative potency of intravenous anesthetics. 1991

D N Stokes, and P Hutton
University Department of Anaesthetics, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, U.K.

To establish anesthesia with minimal respiratory and cardiovascular depression using propofol, the effects of varying the rate of delivery on anesthetic induction dose requirements and hemodynamic changes were studied in four groups of 20 patients each undergoing body surface surgery. All patients were premedicated with temazepam and received 1.5 micrograms/kg fentanyl 5 min before induction. Propofol was delivered at 50, 100, or 200 mg/min by the Ohmeda 9000 infusion pump (groups 1, 2, and 3, respectively) or by bolus of 2 mg/kg (group 4) until loss of verbal contact. Anesthesia was maintained thereafter with propofol infused at 6 mg.kg-1.h-1. Using slower infusion rates, induction took significantly longer (124, 92, 62, and 32 s in groups 1, 2, 3, and 4, respectively) and was achieved with significantly smaller doses of propofol (1.40, 1.96, 2.61, and 2.15 mg/kg in groups 1, 2, 3, and 4, respectively). Slow infusion (groups 1 and 2) caused less depression of systolic and diastolic blood pressure than rapid infusion (groups 3 and 4), but the differences were not statistically significant. Patients in groups 3 and 4 had significantly greater decreases in pulse rate and a greater incidence of apnea than did patients in group 1. There was no correlation between the size of the induction dose and subsequent maintenance requirements of propofol. The finding that the sleep dose of propofol is reduced at slower infusion rates has important practical and theoretical implications when considering the relative potencies of intravenous anesthetics.

UI MeSH Term Description Entries
D007260 Infusion Pumps Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders. Drug Infusion Systems,Infusion Pump,Infusion Pumps, External,Infusors,Intravenous Drug Delivery System,Intravenous Drug Delivery Systems,Perfusion Pumps,Pumps, Infusion,Drug Infusion System,External Infusion Pump,External Infusion Pumps,Infusion Pump, External,Infusion System, Drug,Infusion Systems, Drug,Infusor,Perfusion Pump,Pump, External Infusion,Pump, Infusion,Pump, Perfusion,Pumps, External Infusion,Pumps, Perfusion,System, Drug Infusion,Systems, Drug Infusion
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011229 Preanesthetic Medication Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic. Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D003258 Consumer Behavior Behavior associated with the procurement of goods, services, or experiences. Consumer Preference,Consumer Satisfaction,Behavior, Consumer,Behaviors, Consumer,Consumer Behaviors,Consumer Preferences,Preference, Consumer,Preferences, Consumer,Satisfaction, Consumer
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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