Jun 13, 2020

The role of pharmacokinetics and pharmacodynamics in clinical anaesthesia practice

Current Opinion in Anaesthesiology
Laura N HannivoortMichel M R F Struys

Abstract

Growing concerns about the environmental effects of volatile anaesthetics are likely to lead to increased use of intravenous anaesthetic drugs. Pharmacokinetic/pharmacodynamic (PKPD) models can increase the accuracy of intravenous drug titration, especially in populations that differ from the 'average.' However, with a growing number of PKPD models, and other technology available to date, it can be hard to see the wood for the trees. This review attempts to guide the reader through the PKPD jungle. General purpose PKPD models for propofol and remifentanil designed to apply to a broader population, including children, the elderly and the obese, reduce the need for population-specific models. PKPD models for drugs such as dexmedetomidine and antimicrobial agents may be useful for procedural sedation or in the ICU. Technological advances such as Bayesian model adjustment based on point-of-care plasma concentration measurements, closed-loop drug delivery and artificial intelligence may improve the ease of use of the anaesthetic drugs and increase the accuracy of titration. Newer and more complex modelling techniques and technological advancements can help to deliver anaesthetic drugs, sedatives and other drugs in a more stable and ...Continue Reading

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Mentioned in this Paper

Immunoglobulins, Intravenous
Pharmacologic Substance
Volatile liquid anesthetic agent
Point of Care Testing
Trees (plant)
Population Group
Drug Kinetics
Intensive Care Unit
Intravenous
Titration Method

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