Anesthetic management of a hyper-obese patient by target-controlled infusion (TCI) of propofol and fentanyl
Saijo, H.; Nagata, O.; Kitamura, T.; Fujiwara, H.; Hagiwara-Oguchi, K.; Ide, Y.; Tagami, M.; Hanaoka, K.
Masui. Japanese Journal of Anesthesiology 50(5): 528-531
2001
ISSN/ISBN: 0021-4892 PMID: 11424472 Document Number: 534586
We gave total intravenous anesthesia to an over-100% hyper-obese patient using target-controlled infusion (TCI) of propofol and fentanyl. To keep him asleep, we maintained his BIS in a range of 40 to 60 by adjusting the target concentration of propofol. For the target concentration of fentanyl, we chose 2 ng cntdot ml-1 at incision and 1.6 ng cntdot ml-1 during the operation. At the patient's emergence from anesthesia, his estimated blood concentration of propofol was 1.51 mug cntdot ml-1 and his BIS was 80. The relationship between BIS value and effect-site concentration of propofol was almost the same as that assessed in ordinary adults of a normal weight. We conclude that the estimated concentration of propofol is a good indicator of the effect of propofol and that TCI is a useful technique in obese patients as well as in ordinary adults.