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Estimation of the plasma effect site equilibration rate constant of sufentanil in children using the time to peak effect of heart rate and blood pressure.

Song IK, Lee JH, Jung S, Kim JT, Kim HS - Indian J Pharmacol (2015 Jul-Aug)

Bottom Line: We estimated ke0 of sufentanil in children using the time to peak effect (t peak) method.Shorter measured sufentanil t peak by heart rate compared to blood pressure indicate that the heart rate decrease faster than decreasing of blood pressure.Moreover, the calculated sufentanil ke0 in children depends on the pharmacodynamics parameters.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Objectives: Although targeting the effect site concentration may offer advantages over the traditional forms of administering intravenous anesthetics, it is not applicable for sufentanil in children because its plasma effect site equilibration rate constant (ke0) is not known yet. We estimated ke0 of sufentanil in children using the time to peak effect (t peak) method.

Materials and methods: Under general anesthesia, sufentanil t peak was measured after administration of a submaximal bolus dose by means of the decrease in heart rate, blood pressure and calculated approximate entropy (ApEn) of electroencephalogram in 105 children (age range: 3-11 years). ke0 was estimated using t peak and known sufentanil pharmacokinetic parameters in normal children.

Results: The mean t peaks were measured as 44 ± 22 s and 227 ± 91 s by heart rate and by mean blood pressure respectively. The estimated ke0 were 5.16/min and 0.49/min by heart rate and blood pressure respectively. t peak could not be measured using the ApEn, thus ke0 could not be calculated by ApEn in children.

Conclusions: Shorter measured sufentanil t peak by heart rate compared to blood pressure indicate that the heart rate decrease faster than decreasing of blood pressure. Moreover, the calculated sufentanil ke0 in children depends on the pharmacodynamics parameters.

No MeSH data available.


Changes of heart rate after administration of 0.8 mcg/kg of sufentanil. (a) The heart rate decreased maximally (42 s after injection of sufentanil; arrow) and increased slowly. (b) The heart rate decreased maximally in 40 s after administration (arrow) of sufentanil and remained at the same rate
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Figure 1: Changes of heart rate after administration of 0.8 mcg/kg of sufentanil. (a) The heart rate decreased maximally (42 s after injection of sufentanil; arrow) and increased slowly. (b) The heart rate decreased maximally in 40 s after administration (arrow) of sufentanil and remained at the same rate

Mentions: Demographic data are shown in Table 1. There was a large variability in the baseline heart rate or RR interval because of the wide age range of enrolled children. Time to a maximal decrease of heart rate (largest RR interval) was 44 ± 22 s after administration of the submaximal dose of sufentanil. Calculated ke0 was 5.16/min. There were different patterns of changes of heart rate or RR intervals after reaching the peak effect. The most common pattern was reaching the lowest heart rate, followed by the slow increase in heart rate to reach a steady value [Figure 1a]. Another pattern was a plateau of the lowest heart rate without an increase in heart rate [Figure 1]. However, both patterns had the similar tpeak and differed only after the peak effect (44 vs. 39 s). A third pattern in 10 children showed a continuous decrease in heart rate without reaching the lowest heart rate over the study period. There was no correlation with common characteristics such as age or gender in the third pattern and these data were excluded for calculating the ke0.


Estimation of the plasma effect site equilibration rate constant of sufentanil in children using the time to peak effect of heart rate and blood pressure.

Song IK, Lee JH, Jung S, Kim JT, Kim HS - Indian J Pharmacol (2015 Jul-Aug)

Changes of heart rate after administration of 0.8 mcg/kg of sufentanil. (a) The heart rate decreased maximally (42 s after injection of sufentanil; arrow) and increased slowly. (b) The heart rate decreased maximally in 40 s after administration (arrow) of sufentanil and remained at the same rate
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4527054&req=5

Figure 1: Changes of heart rate after administration of 0.8 mcg/kg of sufentanil. (a) The heart rate decreased maximally (42 s after injection of sufentanil; arrow) and increased slowly. (b) The heart rate decreased maximally in 40 s after administration (arrow) of sufentanil and remained at the same rate
Mentions: Demographic data are shown in Table 1. There was a large variability in the baseline heart rate or RR interval because of the wide age range of enrolled children. Time to a maximal decrease of heart rate (largest RR interval) was 44 ± 22 s after administration of the submaximal dose of sufentanil. Calculated ke0 was 5.16/min. There were different patterns of changes of heart rate or RR intervals after reaching the peak effect. The most common pattern was reaching the lowest heart rate, followed by the slow increase in heart rate to reach a steady value [Figure 1a]. Another pattern was a plateau of the lowest heart rate without an increase in heart rate [Figure 1]. However, both patterns had the similar tpeak and differed only after the peak effect (44 vs. 39 s). A third pattern in 10 children showed a continuous decrease in heart rate without reaching the lowest heart rate over the study period. There was no correlation with common characteristics such as age or gender in the third pattern and these data were excluded for calculating the ke0.

Bottom Line: We estimated ke0 of sufentanil in children using the time to peak effect (t peak) method.Shorter measured sufentanil t peak by heart rate compared to blood pressure indicate that the heart rate decrease faster than decreasing of blood pressure.Moreover, the calculated sufentanil ke0 in children depends on the pharmacodynamics parameters.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

Objectives: Although targeting the effect site concentration may offer advantages over the traditional forms of administering intravenous anesthetics, it is not applicable for sufentanil in children because its plasma effect site equilibration rate constant (ke0) is not known yet. We estimated ke0 of sufentanil in children using the time to peak effect (t peak) method.

Materials and methods: Under general anesthesia, sufentanil t peak was measured after administration of a submaximal bolus dose by means of the decrease in heart rate, blood pressure and calculated approximate entropy (ApEn) of electroencephalogram in 105 children (age range: 3-11 years). ke0 was estimated using t peak and known sufentanil pharmacokinetic parameters in normal children.

Results: The mean t peaks were measured as 44 ± 22 s and 227 ± 91 s by heart rate and by mean blood pressure respectively. The estimated ke0 were 5.16/min and 0.49/min by heart rate and blood pressure respectively. t peak could not be measured using the ApEn, thus ke0 could not be calculated by ApEn in children.

Conclusions: Shorter measured sufentanil t peak by heart rate compared to blood pressure indicate that the heart rate decrease faster than decreasing of blood pressure. Moreover, the calculated sufentanil ke0 in children depends on the pharmacodynamics parameters.

No MeSH data available.