■肥胖是世界范围内日益严重的问题,可以影响各种药物的药效学和药代动力学,包括麻醉剂,导致某些药物的剂量不足或过量。对于肥胖人群的理想给药方案尚无共识。
■在这项研究中,2用于麻醉诱导的丙泊酚基于重量的剂量在起效时间方面进行比较,麻醉的充分性,以及对血液动力学指标的影响(例如,心率[HR]和血压)。
■在这个随机的,双盲临床试验,40例病态肥胖(MO)患者计划进行减肥手术,体重指数(BMI)>35,年龄18-59岁,美国麻醉医师协会(ASA-PS)II和III随机分为2组,使用块随机化方法,根据无脂质量(FFM)组或理想体重(IBW)组接受2mg/kg丙泊酚进行麻醉诱导。主要结果是达到脑电双频指数(BIS)≤60的持续时间。睫毛反射消失的时间,麻醉不足的迹象(即,BIS>60,插管时紧张,或大开眼界),额外剂量的要求,还比较了血液动力学指标(包括HR和平均动脉压[MAP])。
■FFM组达到BIS≤60的平均时间为134.1s,IBW组为148.7s。这种差异没有统计学意义(P=0.334)。睫毛反射消失的时间在研究组之间也没有显着差异(P=0.814)。然而,FFM组中的2名患者和IBW组中的8名患者显示出麻醉不充分的迹象并且需要额外的剂量。这种差异具有统计学意义(P=0.032)。血液动力学变量,丙泊酚诱导剂量给药前和给药后2分钟在研究组之间具有可比性(干预前MAP的P=0.520,P=0.327,P=0.847,P=0.516,干预后MAP,干预前HR,和干预后的人力资源,分别)。
■丙泊酚给药,基于FFM和IBW,用于麻醉诱导,提供了相当的起效时间和血液动力学效应;然而,就麻醉的充分性而言,与基于IBW的给药相比,基于FFM的给药更有利。
UNASSIGNED: Obesity is a growing problem worldwide and can affect both the pharmacodynamics and pharmacokinetics of various drugs, including anesthetics, resulting in the under-or overdosing of certain drugs. There is no consensus on the ideal dosing regimen for obese populations.
UNASSIGNED: In this study, 2 weight-based dosing of propofol used for induction of anesthesia were compared in terms of the onset of action time, adequacy of anesthesia, and effects on hemodynamic indices (eg, heart rate [HR] and blood pressure).
UNASSIGNED: In this randomized, double-blind clinical trial, 40 patients with morbid obesity (MO) scheduled for bariatric surgery with body mass index (BMI) > 35, age 18 - 59 years, American Society of Anesthesiologists physical status (ASA-PS) II and III were randomly divided into 2 groups, using block randomization method, to receive 2 mg/kg of propofol for induction of anesthesia based on either fat-free mass (FFM) group or ideal body weight (IBW) group. The primary outcome was the time duration to reach the bispectral index (BIS) ≤ 60. Time to the disappearance of eyelash reflex, signs of inadequate anesthesia (ie, BIS > 60, straining during intubation, or eye-opening), requirements for additional doses, and hemodynamic indices (including HR and mean arterial pressure [MAP]) were also compared.
UNASSIGNED: The mean time to reach BIS ≤ 60 was 134.1 s in the FFM group and 148.7 s in the IBW group. This difference was not statistically significant (P = 0.334). The time of disappearance of eyelash reflex was also not significantly different between the study groups (P = 0.814). However, 2 patients in the FFM group and 8 patients in the IBW group showed signs of inadequate anesthesia and required additional doses. This difference was statistically significant (P = 0.032). Hemodynamic variables, before and 2 min after propofol induction dose administration were comparable between the study groups (P = 0.520, P = 0.327, P = 0.847, P = 0.516 for pre-intervention MAP, post-intervention MAP, pre-intervention HR, and post-intervention HR, respectively).
UNASSIGNED: Propofol dosing, based on FFM and IBW, for induction of anesthesia, provides comparable onset time of action and hemodynamic effects; however, in terms of the adequacy of anesthesia, the dosing based on FFM is more favorable compared to the dosing based on IBW.