• Young-Eun Jang, Sang-Hwan Ji, Ji-Hyun Lee, Eun-Hee Kim, Jin-Tae Kim, and Hee-Soo Kim.
• Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea, #101 Daehak-no, Jongno-gu, 03080, Seoul, Republic of Korea.
• BMC Anesthesiol. 2021 Sep 9; 21 (1): 222.

BackgroundContinuous infusion of propofol has been used to achieve sedation in children. However, the relationship between the effect-site concentration (Ce) of propofol and sedation scale has not been previously examined. The objective of this study was to investigate the relationship between the Ce of propofol and the University of Michigan Sedation Scale (UMSS) score in children with population pharmacodynamic modeling.MethodsA total of 30 patients (aged 3 to 6 years) who underwent surgery under general anesthesia with propofol and remifentanil lasting more than 1 h were enrolled in this study. Sedation levels were evaluated using the UMSS score every 20 s by a 1 μg/mL stepwise increase in the Ce of propofol during the induction of anesthesia. The pharmacodynamic relationship between the Ce of propofol and UMSS score was analyzed by logistic regression with nonlinear mixed-effect modeling.ResultsThe estimated Ce50 (95% confidence interval) of propofol to yield UMSS scores equal to or greater than n were 1.84 (1.54-2.14), 2.64 (2.20-3.08), 3.98 (3.66-4.30), and 4.78 (4.53-5.03) μg/mL for n = 1, 2, 3, and 4, respectively. The slope steepness for the relationship of the Ce versus sedative response to propofol (95% confidence interval) was 5.76 (4.00-7.52).ConclusionsWe quantified the pharmacodynamic relationship between the Ce of propofol and UMSS score, and this finding may be helpful to predict the sedation score at the target Ce of propofol in children.Trial Registrationhttp://www.clinicaltrials.gov (No.: NCT03195686 , Date of registration: 22/06/2017).© 2021. The Author(s).

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