The effect of obesity on the ED(95) of propofol for loss of consciousness in children and adolescents

Anesthesia and Analgesia
Olutoyin A OlutoyeMehernoor F Watcha

Abstract

Anesthesiologists face a dilemma in determining appropriate dosing of anesthetic drugs in obese children. In this study we determined the dose of propofol that caused loss of consciousness in 95% (ED(95)) of obese and nonobese children as determined by loss of eye lash reflex. Forty obese (body mass index [BMI] > 95th percentile for age and gender) and 40 normal weight (BMI 25th to 84th percentile) healthy ASA 1 to 2 children ages 3 to 17 years presenting for surgical procedures were studied using a biased coin design. The primary endpoint was loss of lash reflex at 20 seconds after propofol administration. The first patient in each group received 1.0 mg/kg of IV propofol, and subsequent patients received predetermined propofol doses based on the lash reflex response in the previous patient. If the lash reflex was present, the next patient received a dose increment of 0.25 mg/kg. If the lash reflex was absent, the next patient was randomized to receive either the same dose (95% probability) or a dose decrement of 0.25 mg/kg (5% probability). The ED(95) and 95% confidence intervals (CI) were calculated using isotonic regression and bootstrapping methods respectively. The ED(95) of propofol for loss of lash reflex was significant...Continue Reading

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Sep 13, 2015·Clinical Therapeutics·Jennifer G KendrickMary H H Ensom
Aug 21, 2015·CNS Drugs·Vidya ChidambaranAjay D'Mello
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Jun 6, 2021·Irish Journal of Medical Science·Vesna MarjanovicChristian Breschan
Aug 19, 2014·Veterinary Anaesthesia and Analgesia·Lydia Love, Martha G Cline

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