Cross-simulation between two pharmacokinetic models for the target-controlled infusion of propofol.

Korean journal of anesthesiology
Jong-Yeop KimSang-Kee Min

Abstract

We investigated how one pharmacokinetic (PK) model differed in prediction of plasma (C(p)) and effect-site concentration (C(eff)) using a reproducing simulation of target-controlled infusion (TCI) with another PK model of propofol. Sixty female patients were randomly assigned to TCI using Marsh PK (Group M) and TCI using Schnider PK (Group S) targeting 6.0 µg/ml of C(p) of propofol for induction of anesthesia, and loss of responsiveness (LOR) was evaluated. Total and separate cross-simulation were investigated using the 2 hr TCI data (Marsh TCI and Schnider TCI), and we investigated the reproduced predicted concentrations (MARSH(SCH) and SCHNIDER(MAR)) using the other model. The correlation of the difference with covariates, and the influence of the PK parameters on the difference of prediction were investigated. Group M had a shorter time to LOR compared to Group S (P < 0.001), but C(eff) at LOR was not different between groups. Reproduced simulations showed different time courses of C(p). MARSH(SCH) predicted a higher concentration during the early phase, whereas SCHNIDER(MAR) was maintained at a higher concentration. Volume and clearance of the central compartment were relevant to the difference of prediction, respectively. ...Continue Reading

References

Feb 1, 1988·British Journal of Anaesthesia·T KirkpatrickW S Nimmo
Dec 1, 1987·Anesthesia and Analgesia·E GeptsE J Douglas
Oct 1, 1994·Anesthesiology·E J Youngs, S L Shafer
Jun 9, 1999·Anesthesiology·T W SchniderE J Youngs
Jan 16, 2008·Clinical Pharmacokinetics·Martin WhiteStefan Schraag
Mar 20, 2009·British Journal of Anaesthesia·J B Glen, F Servin
Jun 13, 2009·British Journal of Anaesthesia·A R AbsalomM M R F Struys

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