Validation of fentanyl pharmacokinetics in patients undergoing coronary artery bypass grafting

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
R J HudsonDavid J Peterson

Abstract

The current emphasis on more rapid recovery and earlier tracheal extubation after cardiac surgery requires greater precision in administering opioids to reap their benefits while minimizing the duration of postoperative respiratory depression. Therefore, we aimed to define a pharmacokinetic model that accurately predicts fentanyl concentrations before, during, and after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG). Parameters for two-compartment and three-compartment models were estimated by applying population pharmacokinetic modelling to fentanyl concentration vs time data measured in 29 patients undergoing elective, primary CABG. The ability of these models to predict fentanyl concentrations in a second series of ten patients undergoing CABG was then assessed. A simple, three-compartment model had excellent predictive ability, with a median prediction error (PE = ([Fentanyl]meas - [Fentanyl]pred)/[Fentanyl]pred x 100%) of -0.5%, and a median absolute PE (APE = /PE/) of 14.0%. In comparison to the two-compartment models, linear regression of measured:predicted concentration ratios indicated that the three-compartment model was free of systematic and time-related changes in bias (P...Continue Reading

Citations

Jan 10, 2014·Annals of Cardiac Anaesthesia·Andrei E BautinVladislav N Solntsev
Sep 26, 2003·Anesthesiology·Robert J HudsonJeffrey I Freedman
Oct 23, 2015·Critical Care Medicine·Leena ChoiTimothy D Girard

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