Modeling of Recovery Profiles in Mentally Disabled and Intact Patients after Sevoflurane Anesthesia; A Pharmacodynamic Analysis.
10.3349/ymj.2014.55.6.1624
- Author:
Teo Jeon SHIN
1
;
Gyu Jeong NOH
;
Yong Seo KOO
;
Dong Woo HAN
Author Information
1. Department of Pediatric Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Anesthesia;
general;
mentally disabled persons;
sevoflurane
- MeSH:
*Anesthesia Recovery Period;
Anesthesia, Dental/*methods;
Anesthesia, General/*methods;
Anesthetics, Inhalation/*administration & dosage/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/pharmacology
- From:Yonsei Medical Journal
2014;55(6):1624-1630
- CountryRepublic of Korea
- Language:English
-
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 gamma value were lower in the mentally disabled patients (C50=0.37 vol %, gamma=16.5 in mentally intact patients, C50=0.19 vol %, gamma=4.58 in mentally disabled patients). Mentality was a significant covariate of C50 for ROC and gamma 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.
