Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and nonobese patients : an observational study
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis Group
Abstract
ENGLISH ABSTRACT: Obesity changes body composition including fat free mass (FFM), regarded as the “pharmacologically active mass”. Scaling drug doses to obese patients by total body mass (TBM) results in overdose. We aimed to determine the success rate of inducing anaesthesia in normal, overweight and obese patients with propofol, using an adjusted body mass scalar (ABM), which embodies the increased FFM of obese patients.
Methods: Ninety-six patients were divided into three groups according to body mass index (BMI): normal, overweight and obese. Propofol 2 mg/kg ABM was administered according to the equation: ABM = IBM + 0.4(TBM – IBM), where IBM = ideal body mass. Induction success was assessed clinically and by electroencephalographic spectral entropy.
Results: The groups were similar regarding gender, age, height and IBM. One patient was morbidly obese (BMI = 44). State entropy (SE) decreased to < 60 in 33/33, 28/29 and 33/34 patients in the normal-weight, overweight and obese groups respectively, an overall success rate of 97.5% (95% confidence interval 92.7% to 99.4%). Median lowest achieved SE values and median times that SE remained < 60 did not differ between groups, however the individual values ranged widely in all three groups. Induction failed in the two patients whose SE did not decrease to < 60 (one overweight and one obese).
Conclusions: The ABM-based propofol induction dose has a high success rate in normal, overweight and obese patients. Further studies are required to determine the feasibility among morbidly obese patients.
Description
CITATION: Smith, F. J., et al. 2019. Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and nonobese patients : an observational study. Southern African Journal of Anaesthesia and Analgesia, 25(1):6-11, doi:10.1080/22201181.2018.1475036.
The original publication is available at https://www.tandfonline.com
The original publication is available at https://www.tandfonline.com
Keywords
Body compositions, Anesthetics, Propofol -- Administration, Drugs -- Dosage
Citation
Smith, F. J., et al. 2019. Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and nonobese patients : an observational study. Southern African Journal of Anaesthesia and Analgesia, 25(1):6-11, doi:10.1080/22201181.2018.1475036