Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

BackgroundTarget-controlled infusion (TCI) systems incorporating pharmacokinetic (PK) or PK-pharmacodynamic (PK-PD) models can be used to facilitate drug administration. Existing were developed using data from select populations, the use of which is, strictly speaking, limited these populations. Recently a propofol PK-PD model was for broad population range. The aim study prospectively validate this in children, adults, older subjects, and obese adults undergoing general anaesthesia.MethodsThe 25 subjects included each four groups stratified by age weight. Subjects received through TCI with Eleveld model, titrated bispectral index (BIS) 40–60. Arterial blood samples collected at 5, 10, 20, 30, 40, 60 min after start infusion, every 30 thereafter, maximum 10 samples. BIS recorded continuously. Predictive performance assessed Varvel criteria.ResultsFor PK, showed bias < ±20% but greater (−27%) subjects. Precision <30% all groups. For PD, wobble <5 units precision close Anaesthetists able achieve intraoperative values 40–60 effect-site target concentrations about 85–140% age-adjusted Ce50.ConclusionsThe predictive arterial plasma predictions low (population) when clinical anaesthesia practice.