Dexmedetomidine's Effects on Propofol TCI: Marsh vs. Schnider Models
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparison of the Effects of Dexmedetomidine on the Induction of Anaesthesia Using Marsh and Schnider Pharmacokinetic Models of Propofol Target-Controlled Infusion
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Wan Mohd Nazaruddin Wan Hassan, Hai Siang Tan, Rhendra Hardy Mohamed Zaini
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Comparison of the Effects of Dexmedetomidine on the Induction of Anaesthesia Using Marsh and Schnider Pharmacokinetic Models of Propofol Target-Controlled Infusion
Year: 2018 | Doi: 10.21315/mjms2018.25.1.4
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Dexmedetomidine is a selective alpha-2-adrenoreceptor agonist utilized for its sedative, hypnotic, and analgesic properties, often in conjunction with general anesthesia. This study aimed to evaluate the impact of dexmedetomidine on the induction of anesthesia through different pharmacokinetic models—Marsh and Schnider—during target-controlled infusion (TCI) of propofol in patients undergoing elective surgery. By comparing the effects of dexmedetomidine co-induction on parameters such as target concentration for successful induction and induction time, the research aimed to enhance our understanding of its role in anesthesia.
Effect of Dexterous Co-Induction on Target Concentration and Induction Time
The results demonstrated that the target concentration at which successful induction occurred was significantly lower in the Schnider group compared to the Marsh group (3.48 μg/mL vs. 4.02 μg/mL). Additionally, the induction time was notably shorter for the Schnider model (134.96 seconds) in contrast to the Marsh model (161.59 seconds). Despite these differences, no significant discrepancies were observed in the hemodynamic parameters, indicating that dexmedetomidine effectively reduced the required concentration for induction and hastened the induction process without adversely affecting stability during anesthesia.
Conclusion
The inclusion of dexmedetomidine during anesthesia induction not only reduced the required target concentration for successful anesthesia induction but also shortened the induction time when using the Schnider pharmacokinetic model compared to the Marsh model. The findings suggest that incorporating baseline groups without dexmedetomidine in future studies could further validate these results and potentially highlight a propofol-sparing effect across both models. By refining the application of dexmedetomidine in anesthesia, healthcare practitioners can enhance patient safety and optimize anesthesia management.
FAQ section (important questions/answers):
What was the aim of the study on dexmedetomidine?
The study aimed to determine how dexmedetomidine affects the induction of anaesthesia with propofol target-controlled infusion (TCI) using two different pharmacokinetic models: Marsh and Schnider.
How many patients participated in the anaesthesia dexmedetomidine study?
Sixty-four patients aged between 18 and 60 years, classified as ASA class I-II, were randomized into two equal groups: Marsh and Schnider, each consisting of 32 patients.
What were the key findings regarding the Schnider group?
The Schnider group required a significantly lower target concentration of propofol for successful induction and had a shorter induction time compared to the Marsh group, demonstrating dexmedetomidine's effect on induction.
What was concluded about dexmedetomidine's role in anaesthesia?
Dexmedetomidine reduced the propofol target concentration requirement and induction time in the Schnider model compared to the Marsh model, highlighting its potential effectiveness as a co-induction agent.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Dexmedetomidine's Effects on Propofol TCI: Marsh vs. Schnider Models”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
A table refers to a structured arrangement of data, often organized in rows and columns. In the context of research articles, tables present quantitative results, demographic information, and variable comparisons, aiding in the clear and concise communication of complex data for readers, facilitating easier understanding and analysis of the study's findings.
2) Study (Studying):
A study is a systematic investigation aimed at discovering new knowledge or confirming existing facts. In medical contexts, studies assess the efficacy and safety of treatments, like dexmedetomidine in anesthesia. They contribute significantly to medical literature, forming the evidence base for best practices and clinical guidelines.
3) Drug:
A drug is a substance used for medical treatment, diagnosis, or prevention of disease. In anesthesiology, drugs like dexmedetomidine and propofol are critical for managing patients' sedation and pain control. Understanding drug actions, interactions, and side effects is essential for ensuring patient safety and effective therapeutic outcomes.
4) Blood:
Blood is a vital fluid in the body, comprising red and white cells, platelets, and plasma. It plays a crucial role in delivering oxygen and nutrients to cells and removing waste products. Monitoring blood parameters is essential in anesthesia for assessing patient health, guiding treatment decisions, and ensuring safe procedures.
5) Wolf:
Wolf, in the context of research or publications, often refers to an author's surname. Recognizing authors and their contributions is important for crediting research efforts. Their insights and innovative ideas help advance fields like anesthesiology, guiding practices and policies that affect patient care and treatment strategies.
6) Calculation:
Calculation involves mathematical processes to derive values from data. In clinical trials, accurate calculations are essential for determining sample sizes, statistical significance, and treatment dosages. It ensures reliable results and conclusions, affecting the interpretation of study outcomes and their application to clinical practice in medicine.
7) Performance:
Performance refers to how well a drug or treatment works in achieving desired outcomes. In anesthesia studies, evaluating the performance of various pharmacokinetic models helps determine the most effective methods for inducing anesthesia, informing healthcare professionals about which protocols lead to optimal patient safety and satisfaction.
8) Rules:
Rules are established guidelines or principles that govern conduct or procedures. In clinical research, rules can refer to ethical guidelines, data reporting standards, and regulatory requirements. Following these rules ensures research integrity, protects participant rights, and enhances the credibility of study findings in medical literature.
9) Male:
Male refers to one of the two primary biological sexes in humans. In clinical studies, identifying male and female participants helps researchers analyze sex-based differences in treatment responses or side effects. Such comparisons enhance the understanding of how sex influences pharmacokinetics and patient outcomes in anesthetic practices.
10) Pharmacology:
Pharmacology is the scientific study of drugs, including their effects, mechanisms, and interactions within the body. It is essential for understanding how anesthetic agents like propofol and dexmedetomidine work, guiding clinicians in making informed decisions regarding drug selection, dosages, and monitoring patient responses during procedures.
11) Depression:
Depression, in a medical context, typically refers to a state of reduced physiological or psychological function. In anesthesia, avoiding respiratory depression is crucial as it can lead to serious complications. Understanding how anesthetic agents affect respiration is vital for patient safety when managing sedation and monitoring during surgery.
12) Quality:
Quality reflects the degree of excellence of something, such as medical care or research outcomes. In anesthesia, maintaining high quality of care ensures effective pain management and patient safety. Research quality is assessed through methods, data integrity, and adherence to ethical standards, impacting healthcare practices.
13) Gupta:
Gupta, like Wolf, represents a surname often associated with an author or researcher. Recognition of contributors like Gupta is important in scholarly articles as it highlights their roles in advancing knowledge in fields such as anesthesiology and pharmacology, fostering collaboration and intellectual exchange.
14) Mani:
Mani is another surname associated with researchers in medical literature. Authors like Mani frequently contribute to the body of knowledge, informing best practices in anesthesia management. Understanding their findings helps practitioners apply evidence-based strategies in clinical settings, ultimately enhancing patient care and outcomes.
15) Peng:
Peng is a common surname in academic research, often noted for contributions in fields such as pharmacology or anesthesiology. Recognition of researchers like Peng is vital for understanding the development of medical knowledge, as their published studies can offer insights critical for improving patient management protocols.
16) Post:
Post can refer to 'postoperative,' which describes the period following surgical procedures. Understanding postoperative care, including pain management and the effects of anesthesia on recovery, is crucial in clinical settings. Researching postoperative outcomes informs improvements in practices and patient care strategies post-surgery.
17) Ter:
Ther relates to 'therapy' or therapeutic interventions. In anesthesia, therapy typically includes managing pain and sedation before, during, and after surgery. It encompasses the use of various agents, techniques, and monitoring approaches to ensure optimal patient comfort and safety throughout the surgical experience.
18) Measurement:
Measurement involves quantifying variables or physiological parameters in a clinical study. Accurate measurement is crucial for assessing the effectiveness of treatments, such as drug dosages or patient responses during anesthesia. It ensures reliable data collection that informs the conclusions and implications of research findings.
19) Discussion:
Discussion is a section in scholarly articles where researchers interpret their findings, compare with prior studies, and suggest implications. This section is crucial for understanding the significance of results in clinical practice, as it helps draw connections between research outcomes and their practical applications in patient care.
20) Drowsiness:
Drowsiness refers to a state of near-sleepiness or reduced alertness, often a side effect of certain anesthetic agents. Understanding drowsiness levels in patients undergoing surgical procedures helps anesthesiologists manage sedation effectively, ensuring patient safety while also optimizing the induction and recovery phases of anesthesia.
21) Knowledge:
Knowledge in medical research refers to the accumulated understanding of clinical practices, treatments, and outcomes. It is essential for professionals to stay updated on findings, as advancing knowledge informs best practices in anesthesia administration, ultimately leading to improved patient care and safety in surgical settings.
22) Attending:
Attending refers to a supervisor or senior physician in a clinical setting. Their role is vital in education and training for residents and junior staff. Attending physicians guide treatment decisions, ensuring adherence to established standards of care, particularly in high-stakes environments such as surgical theaters.
23) Vomiting:
Vomiting is a potential postoperative complication associated with anesthesia and certain surgical procedures. Understanding the incidence and management of postoperative nausea and vomiting (PONV) is crucial in improving recovery quality and patient satisfaction, highlighting the importance of adequate preoperative and postoperative care protocols.
24) Disease:
Disease refers to a pathological condition affecting bodily function. In anesthesia, understanding the significance of diseases affecting patients is crucial for tailoring anesthetic management. Awareness of coexisting conditions helps anesthesiologists mitigate risks, optimizing medication dosages and techniques to enhance patient outcomes during surgical procedures.
25) Account:
Account refers to a report or description of an event or situation. In the context of medical studies, maintaining a clear account of methodologies, results, and discussions is crucial. It enhances the transparency and reproducibility of research findings, ensuring that other practitioners can reference or build upon the work accurately.
26) Nausea:
Nausea is a common side effect often experienced after anesthesia and surgery. Understanding its causes and implementing protocols for managing postoperative nausea is essential for improving patient recovery experiences and satisfaction. Researching effective prevention strategies is vital for minimizing this unpleasant symptom post-surgery.
27) Pulse:
Pulse refers to the rhythmic expansion and contraction of arteries as blood is pumped by the heart. Monitoring pulse rates is essential in anesthesia for assessing patient stability and responsiveness during surgical procedures. Abnormal pulse readings can indicate complications, necessitating prompt intervention by medical staff.
Other Science Concepts:
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