Pharmacodynamic analysis of target‑controlled infusion of propofol in patients with hepatic insufficiency

  • Authors:
    • Jing‑Ru Pan
    • Jun Cai
    • Shao‑Li Zhou
    • Qian‑Qian Zhu
    • Fei Huang
    • Yi‑Han Zhang
    • Xin‑Jin Chi
    • Zi‑Qing Hei
  • View Affiliations

  • Published online on: October 19, 2016     https://doi.org/10.3892/br.2016.786
  • Pages: 693-698
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Abstract

The effect of liver dysfunction on target‑controlled infusion (TCI) of propofol remains poorly documented. The pharmacodynamic performance of propofol TCI was evaluated in a cohort of Chinese patients with hepatic insufficiency. Fifty‑three patients with hepatic insufficiency were enrolled in the current prospective, observational study. Anesthesia was induced with propofol via TCI to a plasma concentration of 3 µg/ml. Following loss of consciousness (LOC), fentanyl and cisatracurium were administered. Pharmacodynamic parameters were recorded during TCI, including time to LOC, bispectral index (BIS), heart rate (HR) and blood pressure. Patients were divided into two groups based on model of end stage liver disease (MELD) score: Those with a MELD score of ≤9 and those with a MELD score of ≥10. BIS, mean arterial pressure and HR were demonstrated to vary according to time, but were not affected by liver dysfunction. Hypotension was prominent in patients with a MELD score of ≥10 30 min after induction. The proportion of bradycardia and hypotension at the other time points was not significantly different between MELD scores of ≤9 and ≥10. Notably, no bradycardia was observed in MELD of ≥10. Thus, bradycardia and hypotension was observed in patients with hepatic insufficiency over time, although patients with different severities of hepatic insufficiency did not present with different depths of anesthesia. TCI of propofol to 3 µg/ml may be not suitable for patients with hepatic insufficiency, particularly those with severe liver dysfunction. Predictive concentrations (Cp) of TCI propofol requires further investigation and adjustment in patients with hepatic insufficiency (trial registration no. ChiCTR‑OCH‑12002255).
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December-2016
Volume 5 Issue 6

Print ISSN: 2049-9434
Online ISSN:2049-9442

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Spandidos Publications style
Pan JR, Cai J, Zhou SL, Zhu QQ, Huang F, Zhang YH, Chi XJ and Hei ZQ: Pharmacodynamic analysis of target‑controlled infusion of propofol in patients with hepatic insufficiency. Biomed Rep 5: 693-698, 2016
APA
Pan, J., Cai, J., Zhou, S., Zhu, Q., Huang, F., Zhang, Y. ... Hei, Z. (2016). Pharmacodynamic analysis of target‑controlled infusion of propofol in patients with hepatic insufficiency. Biomedical Reports, 5, 693-698. https://doi.org/10.3892/br.2016.786
MLA
Pan, J., Cai, J., Zhou, S., Zhu, Q., Huang, F., Zhang, Y., Chi, X., Hei, Z."Pharmacodynamic analysis of target‑controlled infusion of propofol in patients with hepatic insufficiency". Biomedical Reports 5.6 (2016): 693-698.
Chicago
Pan, J., Cai, J., Zhou, S., Zhu, Q., Huang, F., Zhang, Y., Chi, X., Hei, Z."Pharmacodynamic analysis of target‑controlled infusion of propofol in patients with hepatic insufficiency". Biomedical Reports 5, no. 6 (2016): 693-698. https://doi.org/10.3892/br.2016.786