Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia

C. Lysakowski, L. Dumont, M. Pellégrini, F. Clerque, E. Tassonyi

Research output: Contribution to journalArticle

149 Citations (Scopus)

Abstract

The bispectral index (BIS) and a sedation score were used to determine and compare the effect of propofol in the presence of fentanyl, alfentanil, remifentanil and sufentanil. Seventy-five non-premedicated patients were assigned randomly into five groups (15 in each) to receive fentanyl, alfentanil, remifentanil, sufentanil or placebo. Opioids were administered using a target-controlled infusion device, to obtain the following predicted effect-site concentrations: fentanyl, 1.5 ng ml-1; alfentanil, 100 ng ml-1; remifentanil, 6 ng ml-1; and sufentanil, 0.2 ng ml-1. After this, a target-controlled infusion of propofol (Diprifusor) was started to increase concentration gradually, to achieve predicted effect-site concentrations of 1, 2, and 4 μg m-1. At baseline and at each successive target effect-site concentration of propofol, the BIS, sedation score and haemodynamic variables were recorded. At the moment of loss of consciousness (LOC), the BIS and the effect-site concentration of propofol were noted. The relationship between propofol effect-site concentration and BIS was preserved with or without opioids. In the presence of an opioid, LOC occurred at a lower effect-site concentration of propofol and at a higher BIS50 (i.e. the BIS value associated with 50% probability of LOC), compared with placebo. Although clinically the hypnotic effect of propofol is enhanced by analgesic concentrations of μ-agonist opioids, the BIS does not show this increased hypnotic effect.

Original languageEnglish
Pages (from-to)523-527
Number of pages5
JournalBritish Journal of Anaesthesia
Volume86
Issue number4
DOIs
Publication statusPublished - 2001

Fingerprint

Sufentanil
Alfentanil
Unconsciousness
Fentanyl
Propofol
Anesthesia
Opioid Analgesics
Hypnotics and Sedatives
Placebos
remifentanil
Analgesics
Hemodynamics
Equipment and Supplies

Keywords

  • Anaesthesia, depth
  • Analgesics opioid
  • Equipment, target-controlled infusion device
  • Interactions (drug)
  • Measurement techniques, bispectral index

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia. / Lysakowski, C.; Dumont, L.; Pellégrini, M.; Clerque, F.; Tassonyi, E.

In: British Journal of Anaesthesia, Vol. 86, No. 4, 2001, p. 523-527.

Research output: Contribution to journalArticle

@article{427b8d2f206b4885a5298c818d24aa23,
title = "Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia",
abstract = "The bispectral index (BIS) and a sedation score were used to determine and compare the effect of propofol in the presence of fentanyl, alfentanil, remifentanil and sufentanil. Seventy-five non-premedicated patients were assigned randomly into five groups (15 in each) to receive fentanyl, alfentanil, remifentanil, sufentanil or placebo. Opioids were administered using a target-controlled infusion device, to obtain the following predicted effect-site concentrations: fentanyl, 1.5 ng ml-1; alfentanil, 100 ng ml-1; remifentanil, 6 ng ml-1; and sufentanil, 0.2 ng ml-1. After this, a target-controlled infusion of propofol (Diprifusor) was started to increase concentration gradually, to achieve predicted effect-site concentrations of 1, 2, and 4 μg m-1. At baseline and at each successive target effect-site concentration of propofol, the BIS, sedation score and haemodynamic variables were recorded. At the moment of loss of consciousness (LOC), the BIS and the effect-site concentration of propofol were noted. The relationship between propofol effect-site concentration and BIS was preserved with or without opioids. In the presence of an opioid, LOC occurred at a lower effect-site concentration of propofol and at a higher BIS50 (i.e. the BIS value associated with 50{\%} probability of LOC), compared with placebo. Although clinically the hypnotic effect of propofol is enhanced by analgesic concentrations of μ-agonist opioids, the BIS does not show this increased hypnotic effect.",
keywords = "Anaesthesia, depth, Analgesics opioid, Equipment, target-controlled infusion device, Interactions (drug), Measurement techniques, bispectral index",
author = "C. Lysakowski and L. Dumont and M. Pell{\'e}grini and F. Clerque and E. Tassonyi",
year = "2001",
doi = "10.1093/bja/86.4.523",
language = "English",
volume = "86",
pages = "523--527",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Effects of fentanyl, alfentanil, remifentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia

AU - Lysakowski, C.

AU - Dumont, L.

AU - Pellégrini, M.

AU - Clerque, F.

AU - Tassonyi, E.

PY - 2001

Y1 - 2001

N2 - The bispectral index (BIS) and a sedation score were used to determine and compare the effect of propofol in the presence of fentanyl, alfentanil, remifentanil and sufentanil. Seventy-five non-premedicated patients were assigned randomly into five groups (15 in each) to receive fentanyl, alfentanil, remifentanil, sufentanil or placebo. Opioids were administered using a target-controlled infusion device, to obtain the following predicted effect-site concentrations: fentanyl, 1.5 ng ml-1; alfentanil, 100 ng ml-1; remifentanil, 6 ng ml-1; and sufentanil, 0.2 ng ml-1. After this, a target-controlled infusion of propofol (Diprifusor) was started to increase concentration gradually, to achieve predicted effect-site concentrations of 1, 2, and 4 μg m-1. At baseline and at each successive target effect-site concentration of propofol, the BIS, sedation score and haemodynamic variables were recorded. At the moment of loss of consciousness (LOC), the BIS and the effect-site concentration of propofol were noted. The relationship between propofol effect-site concentration and BIS was preserved with or without opioids. In the presence of an opioid, LOC occurred at a lower effect-site concentration of propofol and at a higher BIS50 (i.e. the BIS value associated with 50% probability of LOC), compared with placebo. Although clinically the hypnotic effect of propofol is enhanced by analgesic concentrations of μ-agonist opioids, the BIS does not show this increased hypnotic effect.

AB - The bispectral index (BIS) and a sedation score were used to determine and compare the effect of propofol in the presence of fentanyl, alfentanil, remifentanil and sufentanil. Seventy-five non-premedicated patients were assigned randomly into five groups (15 in each) to receive fentanyl, alfentanil, remifentanil, sufentanil or placebo. Opioids were administered using a target-controlled infusion device, to obtain the following predicted effect-site concentrations: fentanyl, 1.5 ng ml-1; alfentanil, 100 ng ml-1; remifentanil, 6 ng ml-1; and sufentanil, 0.2 ng ml-1. After this, a target-controlled infusion of propofol (Diprifusor) was started to increase concentration gradually, to achieve predicted effect-site concentrations of 1, 2, and 4 μg m-1. At baseline and at each successive target effect-site concentration of propofol, the BIS, sedation score and haemodynamic variables were recorded. At the moment of loss of consciousness (LOC), the BIS and the effect-site concentration of propofol were noted. The relationship between propofol effect-site concentration and BIS was preserved with or without opioids. In the presence of an opioid, LOC occurred at a lower effect-site concentration of propofol and at a higher BIS50 (i.e. the BIS value associated with 50% probability of LOC), compared with placebo. Although clinically the hypnotic effect of propofol is enhanced by analgesic concentrations of μ-agonist opioids, the BIS does not show this increased hypnotic effect.

KW - Anaesthesia, depth

KW - Analgesics opioid

KW - Equipment, target-controlled infusion device

KW - Interactions (drug)

KW - Measurement techniques, bispectral index

UR - http://www.scopus.com/inward/record.url?scp=0035057781&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035057781&partnerID=8YFLogxK

U2 - 10.1093/bja/86.4.523

DO - 10.1093/bja/86.4.523

M3 - Article

C2 - 11573626

AN - SCOPUS:0035057781

VL - 86

SP - 523

EP - 527

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 4

ER -