Publication

Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%

van den Berg, J. P., Absalom, A. R., Venema, A. M., Kalmar, A. F., Van Amsterdam, K., Hannivoort, L. N., Proost, J. H., Meier, S., Scheeren, T. W. L., Struys, M. M. R. F. & Vereecke, H. E. M., 3-Jun-2020, In : Journal of clinical monitoring and computing. 11 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

van den Berg, J. P., Absalom, A. R., Venema, A. M., Kalmar, A. F., Van Amsterdam, K., Hannivoort, L. N., Proost, J. H., Meier, S., Scheeren, T. W. L., Struys, M. M. R. F., & Vereecke, H. E. M. (2020). Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%. Journal of clinical monitoring and computing. https://doi.org/10.1007/s10877-020-00540-9

Author

van den Berg, J P ; Absalom, A R ; Venema, A M ; Kalmar, A F ; Van Amsterdam, K ; Hannivoort, L N ; Proost, J H ; Meier, S ; Scheeren, T W L ; Struys, M M R F ; Vereecke, H E M. / Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%. In: Journal of clinical monitoring and computing. 2020.

Harvard

van den Berg, JP, Absalom, AR, Venema, AM, Kalmar, AF, Van Amsterdam, K, Hannivoort, LN, Proost, JH, Meier, S, Scheeren, TWL, Struys, MMRF & Vereecke, HEM 2020, 'Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%', Journal of clinical monitoring and computing. https://doi.org/10.1007/s10877-020-00540-9

Standard

Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%. / van den Berg, J P; Absalom, A R; Venema, A M; Kalmar, A F; Van Amsterdam, K; Hannivoort, L N; Proost, J H; Meier, S; Scheeren, T W L; Struys, M M R F; Vereecke, H E M.

In: Journal of clinical monitoring and computing, 03.06.2020.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

van den Berg JP, Absalom AR, Venema AM, Kalmar AF, Van Amsterdam K, Hannivoort LN et al. Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%. Journal of clinical monitoring and computing. 2020 Jun 3. https://doi.org/10.1007/s10877-020-00540-9


BibTeX

@article{cbd5c7d36078473caddf1117fab21881,
title = "Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%",
abstract = "This prospective study evaluates haemodynamic and electroencephalographic effects observed when administering four combinations of effect-site concentrations of propofol (CePROP) and remifentanil (CeREMI), all yielding a single predicted probability of tolerance of laryngoscopy of 90% (PTOL = 90%) according to the Bouillon interaction model. We aimed to identify combinations of CePROP and CeREMI along a single isobole of PTOL that result in favourable hypnotic and haemodynamic conditions. This knowledge could be of advantage in the development of drug advisory monitoring technology. 80 patients (18–90 years of age, ASA I–III) were randomized into four groups and titrated towards CePROP (Schnider model, ug⋅ml−1) and CeREMI (Minto model, ng⋅ml−1) of respectively 8.6 and 1, 5.9 and 2, 3.6 and 4 and 2.0 and 8. After eleven minutes of equilibration, baseline measurements of haemodynamic endpoints and bispectral index were compared with three minutes of responsiveness measurements after laryngoscopy. Before laryngoscopy, bispectral index differed significantly (p < 0.0001) between groups in concordance with CePROP. Heart rate decreased with increasing CeREMI (p = 0.001). The haemodynamic and arousal responses evoked by laryngoscopy were not significantly different between groups, but CePROP = 3.6 μg⋅ml−1 and CeREMI = 4 ng⋅ml−1 evoked the lowest median value for ∆HR and ∆SAP after laryngoscopy. This study provides clinical insight on the haemodynamic and hypnotic consequences, when a model based predicted PTOL is used as a target for combined effect-site controlled target- controlled infusion of propofol and remifentanil. Heart rate and bispectral index were significantly different between groups despite a theoretical equipotency for PTOL, suggesting that each component of the anaesthetic state (immobility, analgesia, and hypnotic drug effect) should be considered as independent neurophysiological and pharmacological phenomena. However, claims of (in)accuracy of the predicted PTOL must be considered preliminary because larger numbers of observations are required for that goal.",
keywords = "Pharmacology, Interaction, Haemodynamic monitoring, Electroencephalographic monitoring, INTRAOPERATIVE HYPOTENSION, BISPECTRAL INDEX, SEVOFLURANE, PHARMACOKINETICS, MODEL",
author = "{van den Berg}, {J P} and Absalom, {A R} and Venema, {A M} and Kalmar, {A F} and {Van Amsterdam}, K and Hannivoort, {L N} and Proost, {J H} and S Meier and Scheeren, {T W L} and Struys, {M M R F} and Vereecke, {H E M}",
year = "2020",
month = jun,
day = "3",
doi = "10.1007/s10877-020-00540-9",
language = "English",
journal = "Journal of clinical monitoring and computing",
issn = "1387-1307",
publisher = "SPRINGER HEIDELBERG",

}

RIS

TY - JOUR

T1 - Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%

AU - van den Berg, J P

AU - Absalom, A R

AU - Venema, A M

AU - Kalmar, A F

AU - Van Amsterdam, K

AU - Hannivoort, L N

AU - Proost, J H

AU - Meier, S

AU - Scheeren, T W L

AU - Struys, M M R F

AU - Vereecke, H E M

PY - 2020/6/3

Y1 - 2020/6/3

N2 - This prospective study evaluates haemodynamic and electroencephalographic effects observed when administering four combinations of effect-site concentrations of propofol (CePROP) and remifentanil (CeREMI), all yielding a single predicted probability of tolerance of laryngoscopy of 90% (PTOL = 90%) according to the Bouillon interaction model. We aimed to identify combinations of CePROP and CeREMI along a single isobole of PTOL that result in favourable hypnotic and haemodynamic conditions. This knowledge could be of advantage in the development of drug advisory monitoring technology. 80 patients (18–90 years of age, ASA I–III) were randomized into four groups and titrated towards CePROP (Schnider model, ug⋅ml−1) and CeREMI (Minto model, ng⋅ml−1) of respectively 8.6 and 1, 5.9 and 2, 3.6 and 4 and 2.0 and 8. After eleven minutes of equilibration, baseline measurements of haemodynamic endpoints and bispectral index were compared with three minutes of responsiveness measurements after laryngoscopy. Before laryngoscopy, bispectral index differed significantly (p < 0.0001) between groups in concordance with CePROP. Heart rate decreased with increasing CeREMI (p = 0.001). The haemodynamic and arousal responses evoked by laryngoscopy were not significantly different between groups, but CePROP = 3.6 μg⋅ml−1 and CeREMI = 4 ng⋅ml−1 evoked the lowest median value for ∆HR and ∆SAP after laryngoscopy. This study provides clinical insight on the haemodynamic and hypnotic consequences, when a model based predicted PTOL is used as a target for combined effect-site controlled target- controlled infusion of propofol and remifentanil. Heart rate and bispectral index were significantly different between groups despite a theoretical equipotency for PTOL, suggesting that each component of the anaesthetic state (immobility, analgesia, and hypnotic drug effect) should be considered as independent neurophysiological and pharmacological phenomena. However, claims of (in)accuracy of the predicted PTOL must be considered preliminary because larger numbers of observations are required for that goal.

AB - This prospective study evaluates haemodynamic and electroencephalographic effects observed when administering four combinations of effect-site concentrations of propofol (CePROP) and remifentanil (CeREMI), all yielding a single predicted probability of tolerance of laryngoscopy of 90% (PTOL = 90%) according to the Bouillon interaction model. We aimed to identify combinations of CePROP and CeREMI along a single isobole of PTOL that result in favourable hypnotic and haemodynamic conditions. This knowledge could be of advantage in the development of drug advisory monitoring technology. 80 patients (18–90 years of age, ASA I–III) were randomized into four groups and titrated towards CePROP (Schnider model, ug⋅ml−1) and CeREMI (Minto model, ng⋅ml−1) of respectively 8.6 and 1, 5.9 and 2, 3.6 and 4 and 2.0 and 8. After eleven minutes of equilibration, baseline measurements of haemodynamic endpoints and bispectral index were compared with three minutes of responsiveness measurements after laryngoscopy. Before laryngoscopy, bispectral index differed significantly (p < 0.0001) between groups in concordance with CePROP. Heart rate decreased with increasing CeREMI (p = 0.001). The haemodynamic and arousal responses evoked by laryngoscopy were not significantly different between groups, but CePROP = 3.6 μg⋅ml−1 and CeREMI = 4 ng⋅ml−1 evoked the lowest median value for ∆HR and ∆SAP after laryngoscopy. This study provides clinical insight on the haemodynamic and hypnotic consequences, when a model based predicted PTOL is used as a target for combined effect-site controlled target- controlled infusion of propofol and remifentanil. Heart rate and bispectral index were significantly different between groups despite a theoretical equipotency for PTOL, suggesting that each component of the anaesthetic state (immobility, analgesia, and hypnotic drug effect) should be considered as independent neurophysiological and pharmacological phenomena. However, claims of (in)accuracy of the predicted PTOL must be considered preliminary because larger numbers of observations are required for that goal.

KW - Pharmacology

KW - Interaction

KW - Haemodynamic monitoring

KW - Electroencephalographic monitoring

KW - INTRAOPERATIVE HYPOTENSION

KW - BISPECTRAL INDEX

KW - SEVOFLURANE

KW - PHARMACOKINETICS

KW - MODEL

U2 - 10.1007/s10877-020-00540-9

DO - 10.1007/s10877-020-00540-9

M3 - Article

C2 - 32488680

JO - Journal of clinical monitoring and computing

JF - Journal of clinical monitoring and computing

SN - 1387-1307

ER -

ID: 127068562