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Background: Sevoflurane and desflurane are widely used anesthetics and can be simulated in pharmacokinetic models. These models are related to steady state pharmacokinetics, As anesthetic elimination is a non-steady state process, we evaluated the elimination data of volatile anesthetics using a two-compartment model (bi-exponential function). 50, 80, and 90% context-sensitive decrement times were evaluated with this function. These times are related to awakening and cognitive function recovery.
Methods: Forty-eight healthy patients were enrolled for minimal surgery under general anesthesia. They were randomly anesthetized with either sevoflurane or desflurane. At the end of surgery,when the administration of the volatile anesthetics was discontinued,end-tidal concentrations (PE) were recorded for 15 minutes. We calculated and analyzed the fraction of anesthetic concentrations (PE/PE0) using a bi-exponential function (PE0: the last end-tidal concentration of anesthetics during anesthesia).
Results: A bi-exponential function was fit to the elimination data using non-linear mixed-effect modeling. It showed that the anesthetic duration had effects on the coefficients of early and late components and not on the log rate constants. The coefficient of late components increased and the coefficient of early components decreased with prolonged anesthetic duration. Irrespective to the type of anesthetics, prolonged anesthesia did not affect the context-sensitive half-life; however, a prolonged period of time was required to reach 80 and 90% decrement after prolonged anesthesia.
Conclusions: Prolonged anesthetic duration slowed down the elimination of volatile anesthetics. It delayed awakeness and a return to normal cognitive function after anesthesia권호기사
참고문헌 (22건) : 자료제공( 네이버학술정보 )
| 번호 | 참고문헌 | 국회도서관 소장유무 |
|---|---|---|
| 1 | The Effect of Anesthetic Duration on Kinetic and Recovery Characteristics of Desflurane Versus Sevoflurane, and on the Kinetic Characteristics of Compound A, in Volunteers  |
미소장 |
| 2 | Desflurane and sevoflurane in elderly patients during general anesthesia: a double blind comparison. |
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| 3 | Sevoflurane versus desflurane for outpatient anesthesia: a comparison of maintenance and recovery profiles. |
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| 4 | Comparison of Emergence and Recovery Characteristics of Sevoflurane, Desflurane, and Halothane in Pediatric Ambulatory Patients |
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| 5 | Tutorial: Context-Sensitive Decrement Times for Inhaled Anesthetics |
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| 6 | Kinetics of desflurane, isoflurane, and halothane in humans. |
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| 7 | Carpenter RL, Eger EI 2nd, Johnson BH, Unadkat JD, Sheiner LB. Does the duration of anesthetic administration affect the pharmacokinetics or metabolism of inhaled anesthetics in humans? Anesth Analg 1987; 66: 1-8. | 미소장 |
| 8 | Pharmacokinetics of inhaled anesthetics in humans: measurements during and after the simultaneous administration of enflurane, halothane, isoflurane, methoxyflurane, and nitrous oxide. |
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| 9 | Hyperventilation delays clinical induction of desflurane | 소장 |
| 10 | Context-sensitive half-time in multicompartment pharmacokinetic models for intravenous anesthetic drugs. |
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| 11 | Pharmacokinetics, pharmacodynamics, and rational opioid selection. |
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| 12 | Context-Sensitive Half-Times and Other Decrement Times of Inhaled Anesthetics |
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| 13 | Recovery Profile after Inhalation Anesthesia Using Desflurane-N2O-O2 Versus Isoflurane-N2O-O2 |
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| 14 | Recovery Profile after Inhalation Anesthesia Using Sevoflurane and Desflurane |
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| 15 | Inhalation anesthetics: a review |
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| 16 | The effects of ventilation and anesthetic solubility on recovery from anesthesia: an in vivo and analog analysis before and after equilibrium. |
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| 17 | Isoflurane in a drawover anaesthesia system |
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| 18 | Shafer SL. Basic principles of pharmacology. In: Miller's Anesthesia. 7th Ed. Edited by Miller RD: Philadelphia, Churchill Livingstone Elsevier. 2010, pp 479-513. | 미소장 |
| 19 | Concentrations of Desflurane and Propofol That Suppress Response to Command in Humans |
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| 20 | Influence of age on awakening concentrations of sevoflurane and isoflurane. |
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| 21 | Behavioral effects of trace and subanesthetic halothane and nitrous oxide in man. |
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| 22 | Effect of Subanesthetic Concentrations of Enflurane and Halothane on Human Behavior |
미소장 |
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