Das pharmakologische Profil von Sildenafil zeigt neben der PDE5-Inhibition auch eine geringe Aktivität an der PDE6 in der Retina. Dies erklärt visuelle Nebenwirkungen wie Farbsehstörungen, die gelegentlich auftreten. Die orale Bioverfügbarkeit beträgt etwa 40 %, mit einer hohen Bindung an Plasmaproteine. Das Verteilungsvolumen ist groß, sodass die Substanz rasch in verschiedene Gewebe gelangt. Die Metabolisierung erfolgt hepatisch und produziert einen aktiven Metaboliten, der die pharmakologische Wirkung ergänzt. Nebenwirkungen sind dosisabhängig und umfassen Kopfschmerzen, Hautrötung und Dyspepsie. Bei Vergleichen innerhalb der Wirkstoffklasse wird viagra original regelmäßig als Beispiel für eine Substanz mit schneller, aber kurzzeitiger Wirkung aufgeführt.

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J Clin Anest hesiol ,September 2004 ,Vol. 20 ,No . 9 Comparison of BIS and AEP index f or monitoring depth of anesthesia during induction
L i u Ji ng , Cao Jiangbei , et al . Depart ment of A nest hesiology , General Hospit al of PL A Beiji ng 100853 Abstract
Objective
To compare t he performance of bispectral index (B IS) and t he auditory e2 voked response index ( AA I) in detecting transitions in consciousness during anest hesia induction wit h propofol alone or propofol plus fentanyl. Methods
Anest hesia was induced wit h eit her an intravenous infu2 sion of 30 mg kg 1 h 1of propofol plus 2 g/ kg of fentanyl (group PF , n = 20) or propofol alone (group P , n = 20) . B IS , AA I and t he doses of propofol administered were recorded at t he endpoint of unrespon2 siveness to verbal commands. Plasma propofol concentration was also measured. Results
and its plasma concentration required for getting loss of consciousness were significantly lower in group PF t han t hose in group P ( P < 0101) . The mean B IS value at t he loss of consciousness was significantly higher in group PF t han t hat in group P ( P < 0101) . However ,no difference in AA I was found between t he two groups at t he loss of consciousness ( P > 0105) . Conclusion
The AA I can measure t he transition from consciousness to unconsciousness at similar value levels ,regardless of whet her or not fentanyl pretreat ment was added ,whereas t he B IS values in patients in group PF were higher at t his endpoint t han t hose in group P ,suggesting t hat compared wit h B IS ,t he AA I may be a better indicator of t he state of consciousness dur2 ing propofol/ fentanyl anest hesia ,and t hat AA I can detect t he transition of t he state of consciousness inde2pendent of t he anest hesia regimen.
Key words
Anest hesia dept h ; Propofol ; Fentanyl ;Bispectral index ; Auditory evoked potentials J Clin Anest hesiol ,September 2004 ,Vol. 20 ,No . 9 J Clin Anest hesiol ,September 2004 ,Vol. 20 ,No . 9 Gajraj RJ ,Doi M , Mantzaridis H , et al. Analysis of the EEG bispectrum ,auditory evoked potentials and the EEGpower spec2 trum during repeated transitions from consciousness to uncon2 sciousness. Br J Anaesth ,1998 ,80 :46.
Iselin2Chaves IA ,Moalem HE EI , Gan TJ , et al. Changes in t he auditory evoked potentials and t he bispectral index Litvan H ,J ensen EW ,Revuelta M ,et al. Comparison of au2 following propofol or propofol and alfentanil. Anest hesiolo2 ditory evoked potentials and t he A2line ARX Index for mon2 itoring t he hyp notic level during sevoflurane and propofol in2 duction. Acta anaest hesiol Scand ,2002 ,46 : 245.
J ensen EW ,Nygaard M , Henneberg SW. On2line analysis of Bailey PL , Egan TD , Stanley TH. Intravenous opioid anes2 middle latency auditory evoked potentials ( MLA EP) for t hetics. In Miller RD ,eds. Anest hesia ,5t h ed. Philadelp hi2 monitoring dept h of anaest hesia in laboratory rats. Med Eng a : Churchill Livingstone ,2000. 274.
Absalom AR ,Sutcliffe N , Kenny GN. Effects of t he audito2 Mantzaridis H , Kenny GN. Auditory evoked potential in2 ry stimuli of an auditory potential system on level of con2 dex : a quantitative measure of changes in auditory evoked sciousness ,and on t he bispectral index. Br J Anaest h ,2001 , potentials during general anaest hesia. Anaest hesia , 1997 ,

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