Comparison of Fat-Free Mass and Ideal Body Weight Scalar for Anesthetic Induction Dose of Propofol in Patients with Morbid Obesity: A Double-Blind, Randomized Clinical Trial
| Author | Soudabeh Djalalimotlagh | en |
| Author | Mahmoud Reza Mohaghegh | en |
| Author | Mohammad Reza Ghodraty | en |
| Author | Amineh Shafeinia | en |
| Author | Faranak Rokhtabnak | en |
| Author | Tina Alinia | en |
| Author | Farnoosh Tavakoli | en |
| Orcid | Soudabeh Djalalimotlagh [0000-0002-5498-678X] | en |
| Orcid | Mahmoud Reza Mohaghegh [0000-0001-8424-1116] | en |
| Orcid | Mohammad Reza Ghodraty [0000-0003-0062-8562] | en |
| Orcid | Faranak Rokhtabnak [0000-0001-6368-9931] | en |
| Orcid | Tina Alinia [0000-0001-6832-0906] | en |
| Orcid | Farnoosh Tavakoli [0000-0002-7104-4137] | en |
| Issued Date | 2023-12-31 | en |
| Abstract | Background: Obesity is a growing problem worldwide and can affect both the pharmacodynamics and pharmacokinetics of various drugs, including anesthetics, resulting in the under-or overdosing of certain drugs. There is no consensus on the ideal dosing regimen for obese populations. Objectives: In this study, 2 weight-based dosing of propofol used for induction of anesthesia were compared in terms of the onset of action time, adequacy of anesthesia, and effects on hemodynamic indices (eg, heart rate [HR] and blood pressure). Methods: In this randomized, double-blind clinical trial, 40 patients with morbid obesity (MO) scheduled for bariatric surgery with body mass index (BMI) > 35, age 18 - 59 years, American Society of Anesthesiologists physical status (ASA-PS) II and III were randomly divided into 2 groups, using block randomization method, to receive 2 mg/kg of propofol for induction of anesthesia based on either fat-free mass (FFM) group or ideal body weight (IBW) group. The primary outcome was the time duration to reach the bispectral index (BIS) ≤ 60. Time to the disappearance of eyelash reflex, signs of inadequate anesthesia (ie, BIS > 60, straining during intubation, or eye-opening), requirements for additional doses, and hemodynamic indices (including HR and mean arterial pressure [MAP]) were also compared. Results: The mean time to reach BIS ≤ 60 was 134.1 s in the FFM group and 148.7 s in the IBW group. This difference was not statistically significant (P = 0.334). The time of disappearance of eyelash reflex was also not significantly different between the study groups (P = 0.814). However, 2 patients in the FFM group and 8 patients in the IBW group showed signs of inadequate anesthesia and required additional doses. This difference was statistically significant (P = 0.032). Hemodynamic variables, before and 2 min after propofol induction dose administration were comparable between the study groups (P = 0.520, P = 0.327, P = 0.847, P = 0.516 for pre-intervention MAP, post-intervention MAP, pre-intervention HR, and post-intervention HR, respectively). Conclusions: Propofol dosing, based on FFM and IBW, for induction of anesthesia, provides comparable onset time of action and hemodynamic effects; however, in terms of the adequacy of anesthesia, the dosing based on FFM is more favorable compared to the dosing based on IBW. | en |
| DOI | https://doi.org/10.5812/aapm-140027 | en |
| Keyword | Bariatric Surgery | en |
| Keyword | Body Composition | en |
| Keyword | Fat-Free Mass | en |
| Keyword | Ideal Body Weight | en |
| Keyword | Morbid Obesity | en |
| Keyword | Propofol | en |
| Publisher | Brieflands | en |
| Title | Comparison of Fat-Free Mass and Ideal Body Weight Scalar for Anesthetic Induction Dose of Propofol in Patients with Morbid Obesity: A Double-Blind, Randomized Clinical Trial | en |
| Type | Research Article | en |
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