Propofol infusion and the suppression of consciousness: dose requirements to induce loss of consciousness and to suppress response to noxious and non-noxious stimuli

Abstract

We have defined the infusion dose requirements of propofol to suppress consciousness and response to a variety of graded non-noxious and noxious stimuli in 52 unpremedicated patients aged 16-40 yr and 32 patients aged 41-65 yr. They were allocated to receive one of five loading dose-infusion schemes designed to establish stable conditions covering the range from wakefulness, through sedation, to loss of consciousness and anaesthesia. At 10 and 20 min after the loading dose, each patient's response to a graded series of stimuli was recorded. Probit analysis was used to derive mean values (95% confidence interval) for the ED50 and ED95 (as final infusion rate) for loss of response to verbal command at 4.9 (4.7-5.1) mg kg-1 h-1 and 7.9 (7.3-8.8) mg kg-1 h-1, respectively, in the young group and 4.2 (4.0-4.4) mg kg-1 h-1 and 5.8 (5.4-6.4) mg kg-1 h-1, respectively, in the older group. In both groups the dose-response curves for suppression of proprioception, finger counting and perception of light touch in conscious patients were shifted to the left of the curves for loss of consciousness and eyelash reflex. Dose-response curves for noxious stimuli were shifted to the right of those for loss of consciousness.