Abstract
BackgroundThe pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender. The purpose of this study was to compare effect-site half maximal effective concentrations (EC50) of propofol in male and female patients during i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxants.MethodsForty patients, aged 20–46 years of ASA physical status I or II, were allocated to one of two groups by gender (20 patients per group). After the infusion of dexmedetomidine 0.5 μg/kg over 2 min, anesthesia was induced with a pre-determined effect-site concentration of propofol by target controlled infusion. Effect-site EC50 values of propofol for successful i-gel insertion were determined using the modified Dixon’s up-and-down method.ResultsMean effect-site EC50 ± SD of propofol for successful i-gel insertion was significantly higher for men than women (5.46 ± 0.26 μg/ml vs. 3.82 ± 0.34 μg/ml, p < 0.01). The EC50 of propofol in men was approximately 40 % higher than in women. Using isotonic regression with a bootstrapping approach, the estimated EC50 (95 % confidence interval) of propofol was also higher in men [5.32 (4.45–6.20) μg/ml vs. 3.75 (3.05–4.43) μg/ml]. The estimated EC95 (95 % confidence interval) of propofol in men and women were 5.93 (4.72–6.88) μg/ml and 4.52 (3.02–5.70) μg/ml, respectively.ConclusionsDuring i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxant, male patients had higher effect-site EC50 for propofol using Schnider’s model. Based on the results of this study, patient gender should be considered when determining the optimal dose of propofol during supraglottic airway insertion.Trial registrationClinicalTrials.gov identifier: NCT02268656. Registered August 26, 2014.
Highlights
The pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender
According to modified Dixon’s up-and-down method, the effect-site EC50 (± standard deviations (SDs)) of propofol for successful i-gel insertion was significantly higher for men than women (5.46 ± 0.26 vs. 3.82 ± 0.34 μg/ ml, p < 0.01)
By isotonic regression with bootstrapping (Fig. 2), the estimated effect-site EC50 of propofol was higher in men [5.32 (4.60–6.02, 4.45– 6.20) vs. 3.75 (3.18–4.31, 3.05–4.43) μg/ml]
Summary
The pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender. The purpose of this study was to compare effect-site half maximal effective concentrations (EC50) of propofol in male and female patients during i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxants. I-gel has been reported to have several potential advantages, such as, easier insertion and less tissue compression, over other supra-glottic airways with an inflatable cuff [1, 2]. Target controlled infusion (TCI) of propofol is widely used for supra-glottic airway insertion without. The purpose of this study was to compare effect-site EC50 values of propofol in male and female patients during i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxants. We hypothesized that male patients would require higher effect-site EC50 for successful i-gel insertion with dexmedetomidine pretreatment
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