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Influence of administration rate on propofol plasma - Effect site equilibration

Michel Struys UGent, Marc Coppens UGent, N DE NEVE, Eric Mortier UGent, AG DOUFAS, Jan Van Bocxlaer UGent and SL SHAFER (2007) ANESTHESIOLOGY. 107(3). p.386-396
abstract
Background: The authors hypothesized a difference in plasma-effect site equilibration, depicted by a first-order constant k(e0), depending on the injection rate of propofol. Methods: Sixty-one patients received 2.5 mg/kg propofol given as a bolus or as a 1-, 2-, or 3-min infusion. The Bispectral index was used to monitor drug effect. Propofol predicted plasma concentration was calculated using a three-compartment model and the effect site concentration over time as the convolution between the predicted plasma concentration and the disposition function of the effect site concentration. The authors evaluated the influence of the infusion rate on the k(e0) by comparing the model with one k(e0) for all groups with models estimating different k(e0) values for each group. The authors also assessed the accuracy of two pharmacokinetic models after bolus injection. Results: The best model based was a fixed (Bispectral Index t 90) plus sigmoidal model (Bispectral Index < 90) with two values of k(e0), one for the bolus (t, k(e0) = 1.2 min) and one for the infusions (t(1/2) k(e0) = 2.2 min). However, the tested pharmacokinetic models poorly predicted the arterial concentrations in the first minutes after bolus injection. Simulations showed the requirement for two k(e0) values for bolus and infusion was mostly a compensation for the inaccurate prediction of arterial concentrations after a bolus. Conclusion: Propofol plasma-effect site equilibration occurs more rapidly after a bolus than after rapid infusion, based on the electroencephalogram as a drug effect measure, mostly because of misspecification of the pharmacokinetic model in the first minutes after bolus.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (proceedingsPaper)
publication status
published
subject
journal title
ANESTHESIOLOGY
Anesthesiology
volume
107
issue
3
pages
386-396 pages
publisher
LIPPINCOTT WILLIAMS & WILKINS
conference name
13th Annual Meeting of the International Society of Anaesthetic Pharmacology
conference location
Las Vegas
conference start
2007-10-22
conference end
2007-10-22
Web of Science type
Proceedings Paper
Web of Science id
000249297200006
JCR category
ANESTHESIOLOGY
JCR impact factor
4.596 (2007)
JCR rank
2/22 (2007)
JCR quartile
1 (2007)
ISSN
0003-3022
language
English
UGent publication?
yes
classification
A1
id
390967
handle
http://hdl.handle.net/1854/LU-390967
date created
2008-03-04 16:51:00
date last changed
2009-04-29 11:06:34
@article{390967,
  abstract     = {Background: The authors hypothesized a difference in plasma-effect site equilibration, depicted by a first-order constant k(e0), depending on the injection rate of propofol.
Methods: Sixty-one patients received 2.5 mg/kg propofol given as a bolus or as a 1-, 2-, or 3-min infusion. The Bispectral index was used to monitor drug effect. Propofol predicted plasma concentration was calculated using a three-compartment model and the effect site concentration over time as the convolution between the predicted plasma concentration and the disposition function of the effect site concentration. The authors evaluated the influence of the infusion rate on the k(e0) by comparing the model with one k(e0) for all groups with models estimating different k(e0) values for each group. The authors also assessed the accuracy of two pharmacokinetic models after bolus injection.

Results: The best model based was a fixed (Bispectral Index t 90) plus sigmoidal model (Bispectral Index {\textlangle} 90) with two values of k(e0), one for the bolus (t, k(e0) = 1.2 min) and one for the infusions (t(1/2) k(e0) = 2.2 min). However, the tested pharmacokinetic models poorly predicted the arterial concentrations in the first minutes after bolus injection. Simulations showed the requirement for two k(e0) values for bolus and infusion was mostly a compensation for the inaccurate prediction of arterial concentrations after a bolus.

Conclusion: Propofol plasma-effect site equilibration occurs more rapidly after a bolus than after rapid infusion, based on the electroencephalogram as a drug effect measure, mostly because of misspecification of the pharmacokinetic model in the first minutes after bolus.},
  author       = {Struys, Michel and Coppens, Marc and DE NEVE, N and Mortier, Eric and DOUFAS, AG and Van Bocxlaer, Jan and SHAFER, SL},
  issn         = {0003-3022},
  journal      = {ANESTHESIOLOGY},
  language     = {eng},
  location     = {Las Vegas},
  number       = {3},
  pages        = {386--396},
  publisher    = {LIPPINCOTT WILLIAMS \& WILKINS},
  title        = {Influence of administration rate on propofol plasma - Effect site equilibration},
  volume       = {107},
  year         = {2007},
}

Chicago
Struys, Michel, Marc Coppens, N DE NEVE, Eric Mortier, AG DOUFAS, Jan Van Bocxlaer, and SL SHAFER. 2007. “Influence of Administration Rate on Propofol Plasma - Effect Site Equilibration.” Anesthesiology 107 (3): 386–396.
APA
Struys, M., Coppens, M., DE NEVE, N., Mortier, E., DOUFAS, A., Van Bocxlaer, J., & SHAFER, S. (2007). Influence of administration rate on propofol plasma - Effect site equilibration. ANESTHESIOLOGY, 107(3), 386–396. Presented at the 13th Annual Meeting of the International Society of Anaesthetic Pharmacology.
Vancouver
1.
Struys M, Coppens M, DE NEVE N, Mortier E, DOUFAS A, Van Bocxlaer J, et al. Influence of administration rate on propofol plasma - Effect site equilibration. ANESTHESIOLOGY. LIPPINCOTT WILLIAMS & WILKINS; 2007;107(3):386–96.
MLA
Struys, Michel, Marc Coppens, N DE NEVE, et al. “Influence of Administration Rate on Propofol Plasma - Effect Site Equilibration.” ANESTHESIOLOGY 107.3 (2007): 386–396. Print.