Abstract

BackgroundOlder people are currently the fastest growing segment of the worldwide population. The present study aimed to estimate propofol dose in older patients based on size descriptors measured by bioelectrical impedance analysis (BIA).MethodsA cross sectional study in adult and older patients with body mass index equal to or lower than 35 kg/m2 was carried out. BIA and Clinical Frail Scale scoring were performed during pre-operative evaluation. Propofol infusion was started at 2000 mg/h until loss of consciousness (LOC) which was defined by “loss of eye-lash reflex” and “loss of response to name calling”. Total dose of propofol at LOC was recorded. Propofol plasma concentration was measured using gas chromatography/ion trap-mass spectrometry.ResultsForty patients were enrolled in the study. Total propofol dose required to LOC was lower in Age ≥ 65 group and a higher plasma propofol concentration was measured in this group. 60% of old patients were classified as “apparently vulnerable” or “frail” and narrow phase angle values were associated with increasing vulnerability scores. In the Age ≥ 65 group, the correlation analysis showed that the relationship between propofol dose and total body weight (TBW) scaled by the corresponding phase angle value is stronger than the correlation between propofol dose and TBW or fat free mass (FFM).ConclusionsThis study demonstrates that weight-based reduction of propofol is suitable in older patients; however FFM was not seen to be more effective than TBW to predict the propofol induction dose in these patients. Guiding propofol induction dose according to baseline frailty score should also be considered to estimate individualized dosage profiles. Determination of phase angle value appears to be an easy and reliable tool to assess frailty in older patients.Trial registrationClinicalTrials.gov Identifier: NCT02713698. Registered on 23 February 2016.

Highlights

  • Older people are currently the fastest growing segment of the worldwide population

  • Physiologic changes and cognitive dysfunction associated with age, the presence of multiple comorbidities, the use of multiple medications and frailty increase the risk of older patients to adverse postoperative outcomes [1]

  • We proposed to assess changes in phase angle values in frail patients

Read more

Summary

Introduction

Older people are currently the fastest growing segment of the worldwide population. The present study aimed to estimate propofol dose in older patients based on size descriptors measured by bioelectrical impedance analysis (BIA). Older people are currently the fastest growing segment of the worldwide population, and older patients are increasingly submitted to a multiplicity of surgical procedures [1, 2]. Physiologic changes that occur with aging, such as a decrease in total body water, a decrease in lean body weight (LBW) and an increase in body fat, may possibly require the adjustment of propofol doses based on different weight scalars [5, 9]. The adequacy of TBW or other size descriptors as predictors of the propofol dose at LOC has not been studied yet in older patients

Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call