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Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia.
- Source :
-
BJA: The British Journal of Anaesthesia . Feb2021, Vol. 126 Issue 2, p386-394. 9p. - Publication Year :
- 2021
-
Abstract
- <bold>Background: </bold>Target-controlled infusion (TCI) systems incorporating pharmacokinetic (PK) or PK-pharmacodynamic (PK-PD) models can be used to facilitate drug administration. Existing models were developed using data from select populations, the use of which is, strictly speaking, limited to these populations. Recently a propofol PK-PD model was developed for a broad population range. The aim of the study was to prospectively validate this model in children, adults, older subjects, and obese adults undergoing general anaesthesia.<bold>Methods: </bold>The 25 subjects included in each of four groups were stratified by age and weight. Subjects received propofol through TCI with the Eleveld model, titrated to a bispectral index (BIS) of 40-60. Arterial blood samples were collected at 5, 10, 20, 30, 40, and 60 min after the start of propofol infusion, and every 30 min thereafter, to a maximum of 10 samples. BIS was recorded continuously. Predictive performance was assessed using the Varvel criteria.<bold>Results: </bold>For PK, the Eleveld model showed a bias < ±20% in children, adults, and obese adults, but a greater bias (-27%) in older subjects. Precision was <30% in all groups. For PD, the bias and wobble were <5 BIS units and the precision was close to 10 BIS units in all groups. Anaesthetists were able to achieve intraoperative BIS values of 40-60 using effect-site target concentrations about 85-140% of the age-adjusted Ce50.<bold>Conclusions: </bold>The Eleveld propofol PK-PD model showed predictive precision <30% for arterial plasma concentrations and BIS predictions with a low (population) bias when used in TCI in clinical anaesthesia practice. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PROPOFOL
*ANESTHESIA
*DRUG administration
*BLOOD sampling
*PHARMACOKINETICS
*BIOLOGICAL models
*OBESITY
*RESEARCH
*GENERAL anesthesia
*INTRAVENOUS therapy
*BODY weight
*AGE distribution
*RESEARCH methodology
*EVALUATION research
*MEDICAL cooperation
*INTRAVENOUS anesthetics
*COMPARATIVE studies
*LONGITUDINAL method
RESEARCH evaluation
Subjects
Details
- Language :
- English
- ISSN :
- 00070912
- Volume :
- 126
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- BJA: The British Journal of Anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 148141970
- Full Text :
- https://doi.org/10.1016/j.bja.2020.10.027