تاثير العمر في التراكيز البلازمية للبروبوفول باستخدام التسريب المضبوط الهدف في جراحة القلب

Background& Objective: Total intra venous anesthesia based on propofol has been proposed as a safe anesthetic procedure in cardiac surgery. Age-related changes in pharmacology explain why propofol dose requirement should be reduced in elderly patients. In the absence of depth anesthesia monitoring, not reducing the dose could cause adverse cardiovascular effects resulting from propofol overdose in elderly patients. We assessed the influence of age on plasma concentrations of propofol via target controlled infusion accompanied by using bispectral index score during cardiac surgery. Materials & Methods: Forty-two patients received propofol via target controlled infusion. plasma concentrations of propofol were adapted to bispectral index score (40–60). The influence of age on plasma concentrations was assessed by dividing patients into two groups: young (<65 yr) and elderly (≥65 yr). Results: For a similar depth of anesthesia, plasma concentrations of propofol were lower in elderly patients(1,5-2) µg ml–1 at the different stages of cardiac surgery. The mean dose of propofol required to perform tracheal intubation was lower in elderly patients(1,3-2) µg ml–1 . However, the overall doses of propofol were comparable in both groups(400-450)mg. Conclusions: In cardiac anesthesia, target concentrations of propofol must be reduced in elderly patients(1,5-2) µg ml–1 at the different stages of cardiac surgery.