naa a22 4500 510743366 CHVBK 20180411083036.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12630-013-0040-6 doi (NATIONALLICENCE)springer-10.1007/s12630-013-0040-6 The fentanyl concentration required for immobility under propofol anesthesia is reduced by pre-treatment with flurbiprofen axetil [Elektronische Daten] [Mitsuharu Kodaka, Mikiko Tsukakoshi, Hideki Miyao, Koichi Tsuzaki, Junko Ichikawa, Makiko Komori] La concentration de fentanyl nécessaire à l'immobilité au cours d'une anesthésie au propofol est diminuée par un prétraitement avec du flurbiprofène axétil Purpose: We hypothesized that nonsteroidal anti-inflammatory drugs decrease the plasma fentanyl concentration required to produce immobility in 50% of patients in response to skin incision (Cp50incision) compared with placebo under target-controlled infusion (TCI) propofol anesthesia. Methods: Sixty-two unpremedicated patients scheduled to undergo gynecologic laparoscopy were randomly assigned to receive placebo (control group) or flurbiprofen axetil 1mg·kg−1 (flurbiprofen group) preoperatively. General anesthesia was induced with fentanyl and propofol, and intubation was performed after succinylcholine 1mg·kg−1. Propofol was administered via a target-controlled infusion (TCI) system (Diprifusor™) set at an effect-site concentration of 5μg·mL−1. Fentanyl was given by a TCI system using the STANPUMP software (Schafer model). The concentration for the first patient was set at 3ng·mL−1 and modified in each group according to the up-down method. Skin incision was performed after more than ten minutes equilibration time. Serum fentanyl concentration, bispectral index (BIS), and hemodynamic parameters were measured two minutes before and after skin incision. The Cp50incision of fentanyl was derived from the mean of the crossovers (i.e., the serum fentanyl concentrations of successive participants who responded and those who did not or vice versa). Results: Ten and 11 independent crossover pairs were collected in the control and flurbiprofen groups, respectively, representing 42 of 62 enrolled patients. The mean (SD) fentanyl Cp50incision was less in the flurbiprofen group [0.84 (0.63) ng·mL−1] than in the control group [1.65 (1.15) ng·mL−1]; P=0.007; however, there were no differences in BIS, blood pressure, or heart rate, between groups. Conclusion: Preoperative flurbiprofen axetil decreased the Cp50incision of fentanyl by 49% during propofol anesthesia without changing the BIS or hemodynamic variables. Canadian Anesthesiologists' Society, 2013 Kodaka Mitsuharu Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut Tsukakoshi Mikiko Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan aut Miyao Hideki Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan aut Tsuzaki Koichi School of Medicine, Keio University, Keio, Japan aut Ichikawa Junko Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut Komori Makiko Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/12(2013-12-01), 1204-1211 0832-610X 60:12<1204 2013 60 12630 https://doi.org/10.1007/s12630-013-0040-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-0040-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kodaka Mitsuharu Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut NATIONALLICENCE 700 1- Tsukakoshi Mikiko Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan aut NATIONALLICENCE 700 1- Miyao Hideki Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan aut NATIONALLICENCE 700 1- Tsuzaki Koichi School of Medicine, Keio University, Keio, Japan aut NATIONALLICENCE 700 1- Ichikawa Junko Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut NATIONALLICENCE 700 1- Komori Makiko Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East 2-1-10 Nishi-Ogu, Arakawa-ku, 116-8567, Tokyo, Japan aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/12(2013-12-01), 1204-1211 0832-610X 60:12<1204 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer