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• W1970437029 abstract "Context Haemodynamic stability during induction is a cornerstone of cardiac anaesthesia. The evaluation of pharmacokinetic models for propofol during induction is lacking. Objective To compare haemodynamics during cardiac anaesthesia induction with two pharmacokinetic models. Design Randomised controlled trial. Setting Department of Cardiothoracic Surgery, São João Hospital; July to December 2010. Patients Ninety consecutive elective adult cardiac surgical patients. Intervention Random assignment to effect-site target-controlled infusion by Marsh (n = 45) or Schnider (n = 45) pharmacokinetic models with an equilibration constant of 1.2 min−1 adapted to Marsh's model. Invasive blood pressure measurements, propofol dose, and bispectral index (BIS) were recorded. After an initial target concentration of 1.5 μg ml−1, concentrations were upward-titrated in 0.5 μg ml−1 increments until the BIS was <50. Results No differences were observed between Marsh and Schnider models in required propofol dose (0.99 ± 0.26 vs. 0.93 ± 0.31 mg kg−1, P = 0.322), decrease in mean blood pressure (25 ± 13 vs. 22 ± 14%, P = 0.192) or the need for vasopressors (20 vs. 24%, P = 0.800), but the use of the Marsh model resulted in a lower predicted effect-site concentration (2.3 ± 0.4 vs. 2.7 ± 0.6 μg ml−1, P = 0.006) and shorter time to induction (296 ± 59 vs. 338 ± 87 s, P = 0.024). There was a greater decrease in mean blood pressure in older patients (>60 years; 29 ± 10 vs. 22 ± 11%, P = 0.004) irrespective of model, but obese (BMI ≥30 kg m−2) and nonobese patients did not differ. Main outcome measures Decrease in mean blood pressure. Conclusion In effect-site targeting with a 1.2 min−1 equilibration constant, Marsh's model is comparable to Schnider's during induction of anaesthesia." @default.
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• W1970437029 date "2012-10-01" @default.
• W1970437029 modified "2023-10-09" @default.
• W1970437029 title "Prospective randomised comparison of Marsh and Schnider pharmacokinetic models for propofol during induction of anaesthesia in elective cardiac surgery" @default.
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• W1970437029 doi "https://doi.org/10.1097/eja.0b013e3283542421" @default.
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