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Modeling of Recovery Profiles in Mentally Disabled and Intact Patients after Sevoflurane Anesthesia; A Pharmacodynamic Analysis

Authors
 Teo Jeon Shin  ;  Gyu-Jeong Noh  ;  Yong-Seo Koo  ;  Dong Woo Han 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(6) : 1624-1630, 2014 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2014
MeSH
Anesthesia Recovery Period* ; Anesthesia, Dental/methods* ; Anesthesia, General/methods* ; Anesthetics, Inhalation/administration & dosage* ; Anesthetics, Inhalation/pharmacology ; Case-Control Studies ; Child ; Child, Preschool ; Consciousness/drug effects ; Dental Care for Disabled/methods* ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Mentally Disabled Persons ; Methyl Ethers/administration & dosage* ; Methyl Ethers/pharmacology
Keywords
Anesthesia ; general ; mentally disabled persons ; sevoflurane
Abstract
PURPOSE:
Mentally disabled patients show different recovery profiles compared to normal patients after general anesthesia. However, the relationship of dose-recovery profiles of mentally disabled patients has never been compared to that of normal patients.
MATERIALS AND METHODS:
Twenty patients (10 mentally disabled patients and 10 mentally intact patients) scheduled to dental surgery under general anesthesia was recruited. Sevoflurane was administered to maintain anesthesia during dental treatment. At the end of the surgery, sevoflurane was discontinued. End-tidal sevoflurane and recovery of consciousness (ROC) were recorded after sevoflurane discontinuation. The pharmacodynamic relation between the probability of ROC and end-tidal sevoflurane concentration was analyzed using NONMEM software (version VII).
RESULTS:
End-tidal sevoflurane concentration associated with 50% probability of ROC (C₅₀) and γ value were lower in the mentally disabled patients (C₅₀=0.37 vol %, γ=16.5 in mentally intact patients, C₅₀=0.19 vol %, γ=4.58 in mentally disabled patients). Mentality was a significant covariate of C₅₀ for ROC and γ value to pharmacodynamic model.
CONCLUSION:
A sigmoid Emanx model explains the pharmacodynamic relationship between end-tidal sevoflurane concentration and ROC. Mentally disabled patients may recover slower from anesthesia at lower sevoflurane concentration at ROC an compared to normal patients.
Files in This Item:
T201403736.pdf Download
DOI
10.3349/ymj.2014.55.6.1624
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100190
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