Does regular medication of antiepileptic drugs affect the pharmacokinetics of free intravenous anesthetics in total venous anesthesia?

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K21039
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0907:Oral science and related fields
• Research Institution: Okayama University
• Principal Investigator: Nakano Mai 岡山大学, 歯学部, 博士研究員 (00967101)
• Project Period (FY): 2022-08-31 – 2024-03-31
• Keywords: 薬物相互作用 / プロポフォール / 抗てんかん薬 / 薬物動態

Outline of Final Research Achievements

The purpose of the present study was conducted in patients taking oral antiepileptic drugs (AED group) and in patients not taking oral antiepileptic drugs (control group) who underwent dental treatments under total intravenous anesthesia to determine how oral antiepileptic drugs affect anesthetic effect and pharmacokinetics of intravenous anesthetic, propofol, i.e., drug-drug interactions. The results showed the awakening time of the AED group was significantly longer than that of the control group, and the depth of anesthesia upon awakening was correlated with the total propofol concentration and the concentration of free propofol released from blood proteins. It was suggested that regular medication of antiepileptic drugs could affect anesthetic effect of propofol, but further investigation of its effect on pharmacokinetics of free propofol is needed.

Free Research Field

歯科麻酔学

Academic Significance and Societal Importance of the Research Achievements

知的障害を有する患者の歯科治療は，常に患者の協力が得られるとは限らず，行動調整を目的としてしばしば全身麻酔下での歯科治療が選択される．また，知的障害を持つ患者はてんかんを合併することが多いため，知的障害者の歯科治療においては抗てんかん薬内服患者に対して全身麻酔を施行する機会が多い．よって，本研究結果は，抗てんかん薬内服患者に対して全身麻酔をする際のエビデンスとして意義のある成果であると考えられる．