Disposition of Remifentanil in Obesity: A New Pharmacokinetic Model Incorporating the Influence of Body Mass

Anesthesiology
Tae Kyun Kimthe Remifentanil Pharmacokinetics in Obesity Investigators

Abstract

The influence of obesity on the pharmacokinetic (PK) behavior of remifentanil is incompletely understood. The aim of the current investigation was to develop a new population PK model for remifentanil that would adequately characterize the influence of body weight (among other covariates, e.g., age) on the disposition of remifentanil in the general adult population. We hypothesized that age and various indices of body mass would be important covariates in the new model. Nine previously published data sets containing 4,455 blood concentration measurements from 229 subjects were merged. A new PK model was built using nonlinear mixed-effects modeling. Satisfactory model performance was assessed graphically and numerically; an internal, boot-strapping validation procedure was performed to determine the CIs of the model. Body weight, fat-free body mass, and age (but not body mass index) exhibited significant covariate effects on certain three-compartment model parameters. Visual and numerical assessments of model performance were satisfactory. The bootstrap procedure showed satisfactory CIs on all of the model parameters. A new model estimated from a large, diverse data set provides the PK foundation for remifentanil dosing calculat...Continue Reading

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Citations

May 17, 2017·Anesthesiology·Steven L Shafer, Dennis M Fisher
Sep 11, 2019·Current Opinion in Anaesthesiology·Johan Raeder
Jun 4, 2020·European Journal of Anaesthesiology·Benedikt PreckelJannicke Mellin-Olsen
Jun 13, 2020·Current Opinion in Anaesthesiology·Laura N HannivoortMichel M R F Struys
May 26, 2018·Current Opinion in Anaesthesiology·Luis I Cortínez, Brian J Anderson
Jan 5, 2021·Anesthesiology·Douglas J Eleveld, Michel M R F Struys
Jul 14, 2020·British Journal of Anaesthesia·Douglas J EleveldMichel M R F Struys
Oct 28, 2017·British Journal of Anaesthesia·K Kuck, T D Egan
Sep 21, 2020·British Journal of Anaesthesia·Talmage D EganThomas W Schnider

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