We wish to thank you foryourcomments1 to the Article "Randomized cross-over clinical trial comparing to pharmacokinetic models of propofol using entropy indices,"2 and we would like to submit some considerations and clarifications. (i) A propofol bolus (1mg/kg) was administered to facilitate airway management in both treatments (Marsh and Schnider). (ii) To avoid sharp entropy index transitions and ensure that the study period corresponded to an anesthetized patient, the index was considered following a delta time, defined as the time between the start of the propofol infusion with the first sequence model until the end of airway management, once the patient reached a stable conscious state. (iii) The statistical tests proposed by Wellek and Blettner3 for the determination of the "carryover" effect did not show significant statistical evidence pointing to an effect of the first treatment over the second one. This indicates that the 20-minute washout period was enough to prevent the first treatment from having an influence on the second. Propofol is short acting, and time to recovery of consciousness ranges between 5 and 10 minutes following bolus administration, due to reduced concentration in a rapid distribution phase lasting 2 to 4 minutes. In our study, the washout period was much longer than this recovery time.
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Colombian Journal of Anestesiology
Print version ISSN 0120-3347
Rev. colomb. anestesiol. vol.46 no.2 Bogotá Apr./June 2018
https://doi.org/10.1097/cj9.0000000000000034
Response letter to the editor
Reply to Letter to the Editor
a Universidad de La Sabana, PROSEIM Research Group, Chía, Colombia.
b School of Medicine, Universidad de La Sabana, Chía, Colombia.
References
1. Torres Cruz J. Comment about “Randomized cross-over clinical trial comparing two pharmacokinetic models of propofol using entropy indices”. Rev Colomb Anestesiol 2017;45: 80-81. [ Links ]
2. Mosquera-Dussán O, Cárdenas A, Botero-Rosas D, et al. Randomized cross-over clinical trial comparing two pharmacokinetic models of propofol using entropy indices. Rev Colomb Anestesiol 2016;44:194-202. [ Links ]
3. Wellek S, Blettner M. On the proper use of the crossover design in clinical trials. Dtsch Arztebl Int 2012;109:276-281. [ Links ]