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Korean Journal of Anesthesiology 1999;36(4):584-589.
DOI: https://doi.org/10.4097/kjae.1999.36.4.584   
Comparison of Context-Sensitive Half-Time from PK-SIM Computer Simulation with Duration of Propofol Infusion and Awakening after Propofol-N2O-O2 Anesthesia.
Seung Jun Lee, Ho Yeong Kil, Sung Mi Hwang, Dae Woo Kim
1Department of Anesthesiology, College of Medicine, Hallym University.
2Department of Anesthesiology, College of Medicine, Catholic University.
Several recent studies have suggested the context-sensitive half-time (CSHT) as a clinically more relevant measure of decreasing drug concentrations after a constant infusion of a given duration. The purpose of this study was to simulate the CSHT using a PK-SIM computer simulation program and compare this with duration of propofol infusion and real awakening time from anesthesia for the evaluation of CSHT as a useful tool of prediction of recovery from anesthesia.
Ninety-five ASA class I or II adult patients (18-55 yrs) scheduled for orthopedic elective surgery were randomly allocated into 5 groups according to duration of propofol infusion. Five groups were Group 1: less than 60 min, Group 2: 61-120 min, Group 3: 121-180 min, Group 4: 181-240 min, and Group 5: 241-300 min. Anesthesia was induced and maintained with propofol-nitrous oxide (67%)-oxygen (33%) according to Prys-Roberts' method. Propofol was discontinued immediately after skin closure and duration of infusion was checked. Duration of infusion, CSHT, and awakening time from anesthesia were compared and evaluated correlationship among them using a correlation coefficient.
Plasma and effect site concentration after 5 hrs infusion of propofol derived from computer simulation was 3.3 microgram/ml. Awakening time for each group was 8.5-11.8 min and plasma CSHT for that was 6.4-9.5 min. The correlation coefficient (r) between duration of propofol infusion and awakening time was 0.98 (p<0.01) and that between CSHT and awakening time was 0.95 (p<0.01).
There were strong relationship among duration of infusion of propofol, awakening time and CSHT. It seems that CSHT could be a good predictor of awakening from propofol-N20-02 general anesthesia.
Key Words: Anesthetics, intravenous, propofol; Pharmacology, Context-sensitive Half-time; Recovery, awakening


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