Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and non-obese patients: an observational study

dc.contributor.authorSmith, Francois Jacobus
dc.contributor.authorJurgens, F.X.
dc.contributor.authorCoetzee, J.F.
dc.contributor.authorBecker, Piet J.
dc.date.accessioned2020-07-16T13:20:37Z
dc.date.available2020-07-16T13:20:37Z
dc.date.issued2019
dc.description.abstractBACKGROUND: 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.en_ZA
dc.description.departmentAnaesthesiologyen_ZA
dc.description.librarianpm2020en_ZA
dc.description.urihttp://www.sajaa.co.za/index.php/sajaaen_ZA
dc.identifier.citationSmith, F. J., Jurgens, F. X., Coetzee, J.F. & Becker, P. J. 2019, 'Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and non-obese patients: an observational study, 'Southern African Journal of Anaesthesia and Analgesia, vol. 25, no. 1, pp. 6-11.en_ZA
dc.identifier.issn2220-1181 (print)
dc.identifier.issn2220-1173 (online)
dc.identifier.other10.1080/22201181.2018.1475036
dc.identifier.urihttp://hdl.handle.net/2263/75320
dc.language.isoenen_ZA
dc.publisherMedpharm Publicationsen_ZA
dc.rights© 2019 The Author(s). This is distributed under the terms of the Creative Commons License [CC BY-NC 4.0].en_ZA
dc.subjectAdministration and dosageen_ZA
dc.subjectBody compositionsen_ZA
dc.subjectPropofolen_ZA
dc.subjectFat free mass (FFM)en_ZA
dc.subjectObesityen_ZA
dc.subjectTotal body mass (TBM)en_ZA
dc.subjectAnaesthesiaen_ZA
dc.subjectAdjusted body mass (ABM)en_ZA
dc.subjectBody mass index (BMI)en_ZA
dc.subject.otherHealth sciences articles SDG-03
dc.subject.otherSDG-03: Good health and well-being
dc.titleInduction of anaesthesia with propofol according to the adjusted ideal body mass in obese and non-obese patients: an observational studyen_ZA
dc.typeArticleen_ZA

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