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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe Phase 1c Trial Comparing the Anaesthetic Pro-perties of Phaxan and Propofol [ACTRN 126000343909] was a double-blind study based on a Bayesian algorithm to determine dose equivalents for effects on the bispectral index. Its aims were to find the dose of Phaxan that caused anesthesia and to compare it with propofol for speed of onset and recovery, cardiovascular and respiratory effects, and other measures of safety and efficacy.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthesiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthetic Drugs\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthesiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthetic Drugs\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAnesthesiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ELike propofol, lipid\u2013free Phaxan causes fast\u2013onset, short\u2013duration anesthesia but with less cardiovascular and respiratory depression and no pain on injection. It could serve as an intravenous alternative to propofol for anesthesia, sedation, and intensive care unit practice.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPreclinical studies show that Phaxan has less of an effect on blood pressure than propofol and a higher therapeutic index (\u0026gt; 30 vs 6, respectively). In humans, the induction dose and duration of anesthesia are the same as those reported for alphaxalone.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EClear and waterlike, Phaxan is an aqueous solution of alphaxalone (Althesin), a neuroactive steroid anesthetic that preceded Phaxan. A water\u2013insoluble intravenous drug that was widely used from 1972 through 1984, Althesin was withdrawn from the market owing to hypersensitivity to the Cremophor EL used to dissolve it.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EColin S. Goodchild, PhD, Monash Institute of Medical Research, Malvern, Australia, presented results from a first\u2013in\u2013human trial comparing propofol and Phaxan.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe Phase 1c Trial Comparing the Anaesthetic Properties of Phaxan and Propofol [ACTRN 126000343909] was a double\u2013blind study based on a Bayesian algorithm to determine dose equivalents for effects on the bispectral index (BIS). Its aims were to find the dose of Phaxan that caused anesthesia and to compare it with propofol for speed of onset and recovery, cardiovascular and respiratory effects, and other measures of safety and efficacy.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ETwenty\u2013four male volunteers with American Society of Anesthesiologists grade 1 (ages, 18 to 33 years; body mass index, 18 to 25 kg\/m\u003Csup\u003E2\u003C\/sup\u003E) were randomized to receive Phaxan (n = 12) or propofol (n = 12). The following study parameters were assessed 90 minutes after drug injection (single\u2013bolus dose): blood pressure, BIS, oxygen saturation, need for airway and ventilatory support, pain on injection, involuntary movements, nausea, and measures of recovery (ie, the Richmond Agitation and Sedation Scale and the Digital Substitution Test).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ENo patients treated with Phaxan complained of pain on injection vs 8 of 12 patients treated with propofol (\u003Cem\u003EP\u003C\/em\u003E = .0013); none needed apnea or airway support vs 9 of 12 in the propofol group (\u003Cem\u003EP\u003C\/em\u003E = .0003; Fisher exact test). Involuntary muscle movement occurred in the propofol\u2013treated group only (n = 3 of 12). Eleven patients in each group were anesthetized to a BIS value \u2264 50: the Phaxan dose was 0.49 mg\/kg (95% CI, 0.55 to 0.46; median, 75% interquartile range [IQR]), and the propofol dose was 2.31 mg\/kg (95% CI, 3.00 to 1.76; median, 75% IQR). The lowest average BIS was 28 for both patients treated with Phaxan and propofol, with no difference between fall and recovery of BIS. Nine patients in each group received doses of drugs that were within the IQR.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe data show that Phaxan lowers blood pressure and heart rate to a lesser degree than that of propofol at doses that result in equivalent central nervous system depression. Data also indicate that Phaxan is as safe and effective as propofol. Future clinical trials are needed to validate the findings of this study and assess other benefits of Phaxan.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/40\/14.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzomhp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}