ArticleJournal of clinical monitoring and computing2021
Context-sensitive decrement times for inhaled anesthetics in obese patients explored with Gas Man®.
Article in Journal of clinical monitoring and computing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Risk factors for postoperative nausea and vomiting after general anesthesia: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Exceedance Probabilities of Log-normal Distributions for One Group, Two Groups, and Meta-analysis of Multiple Two-group Studies, With Application to Analyses of Prolonged Times to Tracheal Extubation.Journal of medical systems · 2023Pooled it
- Predicting postoperative delayed awakening after flexible ureteroscopic lithotripsy based on radiomic features of body composition.Scientific reports · 2026Article
- Modeling drug retention as memory effects in obese patients using fractional and augmented models.Scientific reports · 2025Article
- Economic impact of prolonged tracheal extubation times on operating room time overall and for subgroups of surgeons: a historical cohort study.BMC anesthesiology · 2025Article
- The impact of isoflurane anesthesia on brain metabolism in mice: An MRI and electroencephalography study.NMR in biomedicine · 2024Article
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- Evaluation of the effectiveness of GASMAN anesthesia simulation software combined with case-based learning versus traditional lecture-based learning in inhalation anesthesia education.Frontiers in medicine · 2024Article
- Effect of Body Mass Index on Postoperative Nausea and Vomiting: Propensity Analysis.Journal of clinical medicine · 2020Article
- Enhancing Anesthesia Education and Clinical Practice: A Comprehensive Review of GASMAN Simulation Software.Journal of medical education and curricular developmentReview
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anesthesia care providers and anesthesia decision support tools use mathematical pharmacokinetic models to control delivery and especially removal of anesthetics from the patient's body. However, these models are not able to reflect alterations in pharmacokinetics of volatile anesthetics caused by obesity. The primary aim of this study was to refine those models for obese patients. To investigate the effects of obesity on the elimination of desflurane, isoflurane and sevoflurane for various anesthesia durations, the Gas Man® computer simulation software was used. Four different models simulating patients with weights of 70 kg, 100 kg, 125 kg and 150 kg were constructed by increasing fat weight to the standard 70 kg model. For each modelled patient condition, the vaporizer was set to reach quickly and then maintain an alveolar concentration of 1.0 minimum alveolar concentration (MAC). Subsequently, the circuit was switched to an open (non-rebreathing) circuit model, the inspiratory anesthetic concentration was set to 0 and the time to the anesthetic decrements by 67% (awakening times), 90% (recovery times) and 95% (resolution times) in the vessel-rich tissue compartment including highly perfused tissue of the central nervous system were determined. Awakening times did not differ greatly between the simulation models. After volatile anesthesia with sevoflurane and isoflurane, awakening times were lower in the more obese simulation models. With increasing obesity, recovery and resolution times were higher. The additional adipose tissue in obese simulation models did not prolong awakening times and thus may act more like a sink for volatile anesthetics. The results of these simulations should be validated by comparing the elimination of volatile anesthetics in obese patients with data from our simulation models.
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