General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia?
- Author
- Remco Vellinga, Douglas J. Eleveld, Michel Struys (UGent) and Johannes P. van den Berg
- Organization
- Abstract
- Purpose of reviewThere are various pharmacokinetic-dynamic models available, which describe the time course of drug concentration and effect and which can be incorporated into target-controlled infusion (TCI) systems. For anesthesia and sedation, most of these models are derived from narrow patient populations, which restricts applicability for the overall population, including (small) children, elderly, and obese patients. This forces clinicians to select specific models for specific populations.Recent findingsRecently, general purpose models have been developed for propofol and remifentanil using data from multiple studies and broad, diverse patient groups. General-purpose models might reduce the risks associated with extrapolation, incorrect usage, and unfamiliarity with a specific TCI-model, as they offer less restrictive boundaries (i.e., the patient "doesn't fit in the selected model") compared with the earlier, simpler models. Extrapolation of a model can lead to delayed recovery or inadequate anesthesia. If multiple models for the same drug are implemented in the pump, it is possible to select the wrong model for that specific case; this can be overcome with one general purpose model implemented in the pump.SummaryThis article examines the usability of these general-purpose models in relation to the more traditional models.
- Keywords
- COMPUTER-CONTROLLED INFUSION, PHARMACOKINETIC-MODEL, PROPOFOL, REMIFENTANIL, PHARMACODYNAMICS, PERFORMANCE, anesthetic drug delivery, general-purpose models, propofol, remifentanil, target-controlled infusion
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-01HCHKRKSH1T7XTYPDFTZ2VNAX
- MLA
- Vellinga, Remco, et al. “General Purpose Models for Intravenous Anesthetics, the next Generation for Target-Controlled Infusion and Total Intravenous Anesthesia?” CURRENT OPINION IN ANESTHESIOLOGY, vol. 36, no. 5, Lippincott Williams & Wilkins, 2023, pp. 602–07, doi:10.1097/ACO.0000000000001300.
- APA
- Vellinga, R., Eleveld, D. J., Struys, M., & van den Berg, J. P. (2023). General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia? CURRENT OPINION IN ANESTHESIOLOGY, 36(5), 602–607. https://doi.org/10.1097/ACO.0000000000001300
- Chicago author-date
- Vellinga, Remco, Douglas J. Eleveld, Michel Struys, and Johannes P. van den Berg. 2023. “General Purpose Models for Intravenous Anesthetics, the next Generation for Target-Controlled Infusion and Total Intravenous Anesthesia?” CURRENT OPINION IN ANESTHESIOLOGY 36 (5): 602–7. https://doi.org/10.1097/ACO.0000000000001300.
- Chicago author-date (all authors)
- Vellinga, Remco, Douglas J. Eleveld, Michel Struys, and Johannes P. van den Berg. 2023. “General Purpose Models for Intravenous Anesthetics, the next Generation for Target-Controlled Infusion and Total Intravenous Anesthesia?” CURRENT OPINION IN ANESTHESIOLOGY 36 (5): 602–607. doi:10.1097/ACO.0000000000001300.
- Vancouver
- 1.Vellinga R, Eleveld DJ, Struys M, van den Berg JP. General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia? CURRENT OPINION IN ANESTHESIOLOGY. 2023;36(5):602–7.
- IEEE
- [1]R. Vellinga, D. J. Eleveld, M. Struys, and J. P. van den Berg, “General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia?,” CURRENT OPINION IN ANESTHESIOLOGY, vol. 36, no. 5, pp. 602–607, 2023.
@article{01HCHKRKSH1T7XTYPDFTZ2VNAX,
abstract = {{Purpose of reviewThere are various pharmacokinetic-dynamic models available, which describe the time course of drug concentration and effect and which can be incorporated into target-controlled infusion (TCI) systems. For anesthesia and sedation, most of these models are derived from narrow patient populations, which restricts applicability for the overall population, including (small) children, elderly, and obese patients. This forces clinicians to select specific models for specific populations.Recent findingsRecently, general purpose models have been developed for propofol and remifentanil using data from multiple studies and broad, diverse patient groups. General-purpose models might reduce the risks associated with extrapolation, incorrect usage, and unfamiliarity with a specific TCI-model, as they offer less restrictive boundaries (i.e., the patient "doesn't fit in the selected model") compared with the earlier, simpler models. Extrapolation of a model can lead to delayed recovery or inadequate anesthesia. If multiple models for the same drug are implemented in the pump, it is possible to select the wrong model for that specific case; this can be overcome with one general purpose model implemented in the pump.SummaryThis article examines the usability of these general-purpose models in relation to the more traditional models.}},
author = {{Vellinga, Remco and Eleveld, Douglas J. and Struys, Michel and van den Berg, Johannes P.}},
issn = {{0952-7907}},
journal = {{CURRENT OPINION IN ANESTHESIOLOGY}},
keywords = {{COMPUTER-CONTROLLED INFUSION,PHARMACOKINETIC-MODEL,PROPOFOL,REMIFENTANIL,PHARMACODYNAMICS,PERFORMANCE,anesthetic drug delivery,general-purpose models,propofol,remifentanil,target-controlled infusion}},
language = {{eng}},
number = {{5}},
pages = {{602--607}},
publisher = {{Lippincott Williams & Wilkins}},
title = {{General purpose models for intravenous anesthetics, the next generation for target-controlled infusion and total intravenous anesthesia?}},
url = {{http://doi.org/10.1097/ACO.0000000000001300}},
volume = {{36}},
year = {{2023}},
}
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