Pharmacokinetic mass of fentanyl for postoperative analgesia in lean and obese patients

Background. We previously proposed dosing weights for fentanyl, termed ‘pharmacokinetic mass’, that span the total body weight (TBW) range from 40 to 210 kg. In this study, we examined the relationships among fentanyl doses needed to achieve postoperative analgesia, corresponding plasma fentanyl con...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 2005-09, Vol.95 (3), p.377-383
Main Authors: Shibutani, K., Inchiosa, M. A., Sawada, K., Bairamian, M.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
analgesics
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - blood
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anthropometry
Biological and medical sciences
Body Weight
complications
Dose-Response Relationship, Drug
Female
fentanyl
Fentanyl - administration & dosage
Fentanyl - blood
Humans
Male
Medical sciences
Middle Aged
obesity
Obesity - blood
Pain, Postoperative - blood
Pain, Postoperative - prevention & control
pharmacokinetics
Postoperative Care - methods
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Summary:Background. We previously proposed dosing weights for fentanyl, termed ‘pharmacokinetic mass’, that span the total body weight (TBW) range from 40 to 210 kg. In this study, we examined the relationships among fentanyl doses needed to achieve postoperative analgesia, corresponding plasma fentanyl concentrations, and pharmacokinetic mass in lean and obese patients undergoing abdominal surgery. Methods. A total of 69 patients were studied, with TBW ranging from 48 to181 kg. Fentanyl infusion was used during surgery. After surgery, fentanyl infusion rates were titrated to achieve analgesia without significant respiratory depression. Plasma fentanyl concentrations were measured when an apparent steady analgesic state was obtained. Comparisons were made for dosing requirements and effective plasma concentrations for 37 lean patients (body mass index
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/aei195