Anesthesia, General Clinical Trial
Official title:
Haemodynamic Stability During Induction of General Anesthesia With Propofol and Remifentanil: A Randomized, Controlled, Double-blind Study Comparing Low vs High Propofol Doses.
The study objective is to examine if a high propofol dose is non-inferior to a low dose in respect to hemodynamic stability in healthy patients during induction of general anesthesia with propofol and remifentanil.
Typically, one or more adjuvant medications are administered to supplement induction of
general anesthesia. When combining anesthetic drugs, the hypnotic effects are often
synergistic. Propofol is associated with hypotension and bradycardia and used together with
remifentanil or sedative agents it may give synergistic or additive sedative and hemodynamic
effects.
Claeys (1988) and Fairfield (1991) examined the cardiovascular effects of propofol 2-2.5
mg/kg induction dose and found significant reductions i SBP and SVR and small changes in CO,
SV and HR. De Wit (2016) examined hemodynamic changes in different steady state propofol
serum concentrations, and found a dose dependent SBP reduction, reduction in resistance of
arterial and systemic circulation and a reduction in mean systemic filling pressures (MSFP)
indicative of a reduction in "stressed volumes". The effective dose (ED) 95% for loss of
consciousness for propofol was determined to 1.75 mg/kg when used alone, and 1.38 mg/kg when
used together with remifentanil 0.25 microg/kg/min (total induction dose 1.75 microg/kg
remifentanil) in a study by Koh et al. We want to examine the hemodynamic effects of giving a
low (1.4 mg/kg) vs a high (2.4 mg/kg) propofol dose combined with a moderate remifentanil
dose (about 1.5 microg/kg).
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