Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial

Nalinee Kovitwanawong; Napipada Tangcharoenwathanakul; Maliwan Oofuvong; Maliwan Oearsakul; Nichanun Pichayanukul

doi:10.31584/jhsmr.2023935

Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial

Nalinee Kovitwanawong, Napipada Tangcharoenwathanakul, Maliwan Oofuvong, Maliwan Oearsakul, Nichanun Pichayanukul

Abstract

Objective: We aimed to determine the plasma concentration 50 (CP₅₀) of propofol target controlled infusion (TCI) for successful insertion of four types of supraglottic airway devices (SGD).
Material and Methods: This prospective parallel randomized controlled, double blinded, superiority trial was conducted in June 2012 following approval by the Ethics Committee of the Faculty of Medicine, Prince of Songkla University, Thailand. Effect-site concentrations (Ce) of propofol TCI were determined by the modified Dixon’s up-and-down method. After equilibration was established between the plasma and effect-site concentrations, a Supreme^TM, ProSeal^TM(control groups), I-gel^TM or Laryngeal Tube Suction II^TM devices were inserted. The CP₅₀was determined by dose response logistic curves presented as means and 95% confidence intervals (CI). The General Estimating Equation was used to determine factors associated with hemodynamic changes.
Results: The Ces of TCI propofol requirements in the Supreme^TM, ProSeal^TM, I-gel^TMand Laryngeal Tube Suction II^TMgroups were 5.8, 4.8, 5.6, and 5.8 μg/ml, respectively (effect size [95% CI]: 0.22 [0.06, 0.51], p-value 0.036). The CP₅₀ [95% CIs] in the Supreme^TM, ProSeal^TM, I-gel^TMand Laryngeal Tube Suction II^TM groups were 5.8 [-0.01, 11.6], 4.9 [3.3, 6.5], 5.7 [5.0, 6.3] and 5.5 [4.7, 6.4] μg/ml, respectively. Heart rates and systolic blood pressure were significantly higher in the Laryngeal Tube Suction II^TMgroup than in the ProSeal^TM (p-value<0.01) and I-gel^TMgroups (p-value<0.01
Conclusion: The ProSeal^TM and I-gel^TM are preferred over the Supreme^TMand Laryngeal Tube Suction II^TM devices due to the lower CP₅₀ and hemodynamic changes.

Keywords

effect-site concentration, target controlled infusion of propofol, ProSealTM, Laryngeal Tube Suction IITM, I-gelTM, SupremeTM

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DOI: http://dx.doi.org/10.31584/jhsmr.2023935

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