Caffeine Accelerates Emergence from Isoflurane Anesthesia in Humans: A Randomized, Double-blind, Crossover Study
Fong R, Wang L, Zacny JP, Khokhar S, Apfelbaum JL, Fox AP, Xie Z
Anesthesiology · 42 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- University or hospital
- University of Chicago
- Government
- National Institutes of Health
- Government
- National Institute of General Medical Sciences
- Government
- NIGMS NIH HHS
- Grants
- National Institute of General Medical Sciences (R01 GM116119)
Based on 4 listed funder(s).
Publication
- Published
- 2018-07-25 · Anesthesiology · vol. 129 · issue 5 · pp. 912–920
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 45 citations · more than 96% of similar papers · 4.9× the field average
- Impact
- Top 10% most cited in its field
- References
- 35 works
- Access
- Open access (repository copy)
- Research areas
- Anesthesia and Sedative Agents · Coffee research and impacts · Cardiovascular Syncope and Autonomic Disorders
- Keywords
- Medicine, Isoflurane, Anesthesia, Caffeine, Bispectral index, Placebo, Crossover study, Saline, Adverse effect, Sedation, Pharmacology, Internal medicine
- MeSH
- humans, citrates, isoflurane, caffeine, anesthetics, inhalation, central nervous system stimulants, anesthesia recovery period, cross-over studies, double-blind method, time factors, adult, male
7 authors
From US, CN
- Robert FongUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
- Lingzhi WangUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
- James P. ZacnyUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
- Suhail KhokharUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
- Jeffrey L. ApfelbaumUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
- Aaron P.D. FoxUniversity of Illinois Chicago; University of Chicago; Guangzhou Medical University
Abstract
What we already know about this topic
WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: There are currently no drugs clinically available to reverse general anesthesia. We previously reported that caffeine is able to accelerate emergence from anesthesia in rodents. This study was carried out to test the hypothesis that caffeine accelerates emergence from anesthesia in humans.
Methods
We conducted a single-center, randomized, double-blind crossover study with eight healthy males. Each subject was anesthetized twice with 1.2% isoflurane for 1 h. During the final 10 min of each session, participants received an IV infusion of either caffeine citrate (15 mg/kg, equivalent to 7.5 mg/kg of caffeine base) or saline placebo. The primary outcome was the average difference in time to emergence after isoflurane discontinuation between caffeine and saline sessions. Secondary outcomes included the end-tidal isoflurane concentration at emergence, vital signs, and Bispectral Index values measured throughout anesthesia and emergence. Additional endpoints related to data gathered from postanesthesia psychomotor testing.
Results
All randomized participants were included in the analysis. The mean time to emergence with saline was 16.5 ± 3.9 (SD) min compared to 9.6 ± 5.1 (SD) min with caffeine (P = 0.002), a difference of 6.9 min (99% CI, 1.8 to 12), a 42% reduction. Participants emerged at a higher expired isoflurane concentration, manifested more rapid return to baseline Bispectral Index values, and were able to participate in psychomotor testing sooner when receiving caffeine. There were no statistically significant differences in vital signs with caffeine administration and caffeine-related adverse events.
Conclusions
Intravenous caffeine is able to accelerate emergence from isoflurane anesthesia in healthy males without any apparent adverse effects.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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