Gender Clinical Trial
Official title:
Effect of Gender on the Pharmacokinetics-pharmacodynamics of Propofol and Cisatracurium Besylate
In recent years it has become clear that gender differences exist both in the pharmacokinetics and the pharmacodynamics of drugs related to the practice of anesthesia. Differences in pharmacokinetics are more straightforward to study than differences in clinical effects. However, isolated pharmacokinetic data are of less value if they are not accompanied by measurements of clinical effects. Males are more sensitive than females to propofol. It may therefore be necessary to decrease the propofol dose by 30-40% in males. Females have 20-30% greater sensitivity to the muscle relaxant effects.
Background: In recent years it has become clear that gender differences exist both in the
pharmacokinetics and the pharmacodynamics of drugs related to the practice of anesthesia.
Differences in pharmacokinetics are more straightforward to study than differences in
clinical effects. However, isolated pharmacokinetic data are of less value if they are not
accompanied by measurements of clinical effects. Males are more sensitive than females to
propofol. It may therefore be necessary to decrease the propofol dose by 30-40% in males.
Females have 20-30% greater sensitivity to the muscle relaxant effects.
Methods: Anaesthesia is induced with propofol 2 mg/kg (t0) followed by cisatracurium 0.1
mg/kg 1 min from propofol administration (t2). Patients will be monitored using the
conventionally available bispectral index monitoring for propofol concentrations and
Relaxometer mechanomyograph neuromuscular monitoring for cisatracurium. Serial arterial blood
samples (5 ml) were withdrawn in EDTA-tubes before cisatracurium administration, 1, 3, 5, 7,
10, 13, 16, 19, 22, 25, 30, 60 and 90 min following administration. Blood samples were
assayed in duplicate using high performance liquid chromatograph. Pharmacokinetic analysis
was performed by fitting the cisatracurium blood concentration time profile of individual
patients, to non-compartmental as well as multi-compartmental pharmacokinetic models.
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