Comparison of propofol pharmacokinetic and pharmacodynamic models for awake craniotomy: A prospective observational study

European Journal of Anaesthesiology
Martin SoehleRichard K Ellerkmann

Abstract

Anaesthesia for awake craniotomy aims for an unconscious patient at the beginning and end of surgery but a rapidly awakening and responsive patient during the awake period. Therefore, an accurate pharmacokinetic/pharmacodynamic (PK/PD) model for propofol is required to tailor depth of anaesthesia. To compare the predictive performances of the Marsh and the Schnider PK/PD models during awake craniotomy. A prospective observational study. Single university hospital from February 2009 to May 2010. Twelve patients undergoing elective awake craniotomy for resection of brain tumour or epileptogenic areas. Arterial blood samples were drawn at intervals and the propofol plasma concentration was determined. The prediction error, bias [median prediction error (MDPE)] and inaccuracy [median absolute prediction error (MDAPE)] of the Marsh and the Schnider models were calculated. The secondary endpoint was the prediction probability PK, by which changes in the propofol effect-site concentration (as derived from simultaneous PK/PD modelling) predicted changes in anaesthetic depth (measured by the bispectral index). The Marsh model was associated with a significantly (P = 0.05) higher inaccuracy (MDAPE 28.9 ± 12.0%) than the Schnider model (M...Continue Reading

References

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Apr 23, 2013·Journal of Neurosurgical Anesthesiology·Valeria ConteNino Stocchetti

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Citations

Sep 30, 2016·Journal of Neurosurgical Anesthesiology·Martin SoehleRichard K Ellerkmann
Jul 24, 2018·Minerva anestesiologica·Alexander KulikovAndrey Lubnin
Jul 2, 2016·Current Opinion in Anaesthesiology·Rafael BadenesFederico Bilotta
Dec 23, 2016·Physiological Research·M GrundmanováJ Kuncová
Oct 3, 2019·Medicine·Josefin GrabertMarkus Velten

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