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Colombian Journal of Anestesiology

Print version ISSN 0120-3347

Rev. colomb. anestesiol. vol.45  supl.2 Bogotá Dec. 2017

 

Brief academy

Comment about "Randomized cross-over clinical trial comparing two pharmacokinetic models of propofol using entropy indices"

Jaime Torres Cruza  *  

a E.S.E. Hospital San Rafael de Tunja, Tunja, Colombia


The article, "Clinical cross-section, randomized clinical trial comparing two pharmacokinetic propofol models using entropy indexes",1 published in the July-September 2016 journal, although an interesting and novel idea, it seems to me that a big mistake was made in the study's clinical design, that totally invalidates the results. The fact is that administering a bolus of propofol of 1mg per kg of weight to place a laryngeal mask, after starting the infusion, makes unrealistic the target concentration assigned to the pump, since the infusion pump "ignores" the bolus administration. Under the TCI modality of the intelligent infusion pumps, the pumps themselves admin ister the bolus as needed; in other words, when the anesthetist starts the infusion or increases the target concentration2; if greater anesthetic depth was needed, the target concentration should have been increased, instead of manually administer ing a bolus. Moreover, since each patient acts as his/her own control, this same bolus results in differences in propofol con centrations at each time period, since during each patient's second phase, the bolus is not administered. Furthermore, although the statistical work done by the authors endorse that results are achieved with just14 patients, the fact that the general anesthesia has been assisted with a peripheral nerve block, which may not generate the same results in all patients, represents a major bias of the study, as Dr. Rosero states in his editorial.3

REFERENCES

1. Mosquera-Dussán OL, Cárdenas A, Botero-Rosas DA, Yepes A, Oliveros H, Henao R. Ensayo clínico cruzado y aleatorizado para comparar 2 modelos farmacocinéticos de propofol usando índices de entropía. Rev Colomb Anestesiol. 2016;44:19-202. [ Links ]

2. Struys MM, De Smet T, Glen JI, Vereecke HE, Absalom AR, Schnider TW. The history of target-controlled infusion. Anesth Analg. 2016;122:56-69. [ Links ]

3. Rosero EB. La caracterización de la profundidad de la anestesia durante las infusiones controladas a objetivo: no es un trabajo fácil. Rev Colomb Anestesiol. 2016;44:187-9. [ Links ]

Please cite this article as: Torres Cruz J. Comentario acerca del artículo "Ensayo clínico cruzado y aleatorizado para comparar 2 modelos farmacocinéticos de propofol usando índices de entropía". Rev Colomb Anestesiol. 2017;45:80-81.

Financing The author did not receive any sponsorship for preparing this article.

* Correspondence to: Calle13 27-60, Duitama, Colombia. E-mail address: jtorresc62@yahoo.com

Conflicts of interest

The author has no conflicts of interest to disclose.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License