Your email address will not be published. Save my name, email, and website in this browser for the next time I comment. We use cookies to make your website experience better. Print this page Tweet. The cumulative percent of patients who awoke or were oriented at various blood propofol levels are shown. Each graph depicts the cumulative percent of patients who returned to baseline function for the Trieger test, p-deletion test, and sedation analog scales. Importantly, when patients awoke from the hypnotic effect of propofol, they were almost immediately oriented to person, place, and time fig.
However, recovery of cognitive and psychomotor function occurred at significantly lower propofol concentrations fig. Interestingly, the recovery of cognitive skills closely paralleled the recovery from the sedative effects of propofol.
After obtaining Food and Drug Administration approval for an investigator-sponsored investigational new drug application to study propofol for intravenous sedation, the manufacturer agreed to supply me with the drug and awarded us a small educational grant for the purpose of performing a comparative study involving the use of propofol as an alternative to midazolam for sedation during local and regional anesthesia.
Some 10 years later, half of the propofol sold in the United States was used for intravenous sedation. Propofol Diprivan was initially developed as an alternative to thiopental Pentothal and methohexital Brevital for induction of general anesthesia.
In preparing this article, it is important to acknowledge those who have assisted me with my studies involving propofol and many other new anesthetics, analgesics, and muscle relaxant drugs. I have been very fortunate to have worked under outstanding mentors at the University of California, San Francisco, and with highly supportive colleagues at Stanford University, Washington University, Cedars Sinai Medical Center, and the University of Texas. However, my greatest pleasure in academic medicine has come from my association with an amazing group of bright, hardworking medical students and clinical research fellows see figure, Supplemental Digital Content 1, which shows Dr.
It is to these outstanding individuals, and the more than medical students and clinical research fellows who followed in their footsteps, that I dedicate this Classic Papers Revisited article. Sign In or Create an Account. Advanced Search. Sign In. Skip Nav Destination Article Navigation.
Close mobile search navigation Article navigation. Volume , Issue 6. Previous Article Next Article. Article Navigation. Classic Papers Revisited December White, Ph. This Site. But obviously we will never know.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. Want to reduce pain in your knees and be more active? Eat smarter and reduce your risk for a heart attack? Sleep the entire night so you have more energy during the day?
Take control of your health right now! Thanks for visiting. Don't miss your FREE gift. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more.
Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Stay on top of latest health news from Harvard Medical School. Recent Blog Articles. People can go home clearheaded and free of wooziness soon after their procedures, which increases willingness to undergo ambulatory surgery.
In particular, existing pumps could not deliver the medicine rapidly enough. Glen established a collaboration with a commercial manufacturer, Ohmeda Company, and the resulting apparatus has served as a prototype for a new generation of devices. Subsequently, he advanced deployment of a technology eventually known as target-controlled infusion for propofol. In real time, a computer, programmed with a pharmacokinetic model that describes how the body handles the drug, calculates the amount needed to achieve a particular concentration in the blood or brain, and adjusts infusion rates accordingly.
This method produces more predictable outcomes than can be achieved with manual oversight alone and facilitates subtle regulation of anesthetic depth. Glen persuaded his company to launch a target-controlled infusion program and the resulting system is now available in most countries, although not the US.
In some areas, it is used extensively to deliver propofol for prolonged periods. Clinicians routinely deploy it in operating rooms, intensive care units, emergency departments, and outpatient clinics—and it has dramatically eased and expanded ambulatory procedures.
Propofol is now the standard intravenous anesthetic induction agent in the US and the world, and it has made a vast range of operations and medical tests comfortable and acceptable for people across the globe. Glen, J. An animal model for the investigation of adverse responses to i.
James, R. Synthesis, biological evaluation, and preliminary structure-activity considerations of a series of alkylphenols as intravenous anesthetic agents. Animal studies of the anaesthetic activity of ICI Pharmacology of an emulsion formulation of ICI British J. Stark, R. Coetzee, J. Pharmacokinetic model selection for target controlled infusions of propofol. The development and regulation of commercial devices for the administration of drugs by target controlled infusion, Chapter 2.
Edited by A. Absalom, and K. Critics of art and philosophers of science have long wrestled with the question of what elevates a piece of art or a set of experiments to masterpiece status. In , Henry Jacob Bigelow introduced ether as an anesthetic for surgical patients and changed the face of medicine.
Then, beginning in , as a Research Biologist in Anesthesia at ICI Imperial Chemical Industries , Glen systematically screened chemical libraries in animals to identify a novel lipophilic chemical for use as an intravenous anesthetic. Glen reported the identification and chemical synthesis of propofol and presented animal studies verifying its effectiveness. In collaboration with a chemist at ICI, Roger James, Glen described the synthesis and biological evaluation of a large series of alkyl-substituted phenols, one of which would become the active ingredient in propofol.
0コメント