Abstract
Rational dosing of anaesthetic drugs derives from an understanding of both the pharmacokinetics and dynamics of the compound in use1. This knowledge can be applied to develop strategies to achieve a required therapeutic drug concentration. The pharmacokinetics of intravenous drugs can be described by a polyexponential function2:
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
M. White, M. J. Schenkels, F. H. M. Engbers, A. Vletter, A. L. G. Burm, J.G. Bovill, G. N. C. Kenny, Effect-site modelling of propofol using auditory evoked potentials, Br. J. Anaesth. 82, 333–9 (1999).
S. L. Shafer, K.M.Gregg, Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump, J. Pharmacokin. Biopharm. 20, 147–69 (1992).
S. L. Shafer, Principles of pharmacokinetics and pharmacodynamics. Principles and Practice of Anesthesiology,edited by: D. E. Longnecker, J. H. Tinker, E. C. Morgan, Mosby-Year Book, Inc., St-Louis, 1159–1210(1998)
M. Struys, Study of the optimalization of anaesthetic-hypnotic drug administration during anaesthesia and sedation PhD thesis, Ghent University (1998)
J.G. Wagner, A safe method for rapidly achieving plasma concentration plateaus. Clin. Pharmacol. Therap. 16,691–700(1974).
E. Kruger-Thiemer, Continuous intravenous infusion and multicompartment accumulation. Eur. J. Pharmacol. 4, 317–24 (1968).
D. P. Vaughan, G. T. Tucker, General derivation of the ideal intravenous drug input required to achieve and maintain a constant drug concentration. Theoretical application to lignocaine therapy. Eur. J. Clin. Pharmacol. 10,433–40 (1976).
H. Schwilden, A general method for calculating the dosage scheme in linear pharmacokinetics. Eur. J. Clin. Pharmacol. 20, 379–86 (1981).
S. L. Shafer, Towards optimal intravenous dosing strategies, Sem. Anesth. 12, 222–34 (1993).
T. W. Schnider, C. F. Minto, D. R. Stanski, The effect compartment concept in pharmacodynamic modelling, Anaesth. Pharmacol Rev. 2,204–13(1994).
L. B. Sheiner, D. R. Stanski, S. Vozeh, R. D. Miller, J. Ham, Simultaneous modeling of pharmacokinetics and pharmacodynamics: application to dturbocurarine. Clin. Pharmacol. Therap. 25, 358–71 (1979).
R. J. Jacobs, Infusion rate control algorithms for pharmacokinetic modeldriven drug infusion devices. International Anesthesiology Clinics 33, 65–82 (1995).
J. G. Bovill, Targeting the effect site, in On the Study and Practice of Intravenous Anaesthesia, edited by J. Vuyk, F. Engbers, S. Groen-Mulder S, Kluwer Academic Publishers, Dordrecht, Boston, London (2000).
K. Morita, T. Kazama, S. Sato, K. Ikeda, Effect sites of intravenous anaesthetic agents, in On the Study and Practice of Intravenous Anaesthesia, edited by J. Vuyk, F. Engbers, S. Groen-Mulder S, Kluwer Academic Publishers, Dordrecht, Boston, London (2000).
T. W. Schnider, C. F. Minto, S. L. Shafer, P. L. Gambus, C. Andresen, D. B. Goodale, E. J. Youngs, The influence of age on propofol pharmacodynamics, Anesthesiology 90,1502–16 (1999).
B. Marsh, M. White, N. Morton, G. N. C. Kenny. Pharmacokinetic model driven infusion of propofol in children. Br. J. Anaesth. 67, 41–8 (1991).
R. A. Veselis, P. Glass, A. Dnistrian, R. Reinsel, Performance of computer-assisted continuous infusion at low concentrations of intravenous sedatives. Anesth. Analg. 84, 1049–57 (1997).
J. F. Coetzee, J. B. Glen, C. A. Wium, L. Boshoff, Pharmacokinetic model selection for target controlled infusions of propofol. Anesthesiology 82, 1328–45 (1995).
H. G. Wakeling, J. B. Zimmerman, S. Howell, P. S. A. Glass, Targeting effect-compartment or central compartment concentration of propofol, Anesthesiology 90, 92–7 (1999).
M. M. R. F. Struys, T. De Smet, B. Depoorter, L. F. M. Versichelen, E. P. Mortier, F. J. E. Dumortier, S. L. Shafer, G. Rolly, Comparison of plasma compartment versus two methods for effect compartment-controlled target-controlled infusion for propofol. Anesthesiology 92, 399–406 (2000).
V. Billard, P. L. Gambus, N. Chamoun, D. R. Stanski, S. L. Shafer., A comparison of spectral edge, delta power and bispectral index as EEG measures of alfentanil, propofol and midazolam drug effect. Clin. Pharmacol. Therap. 61, 45–58 (1997).
W. V. Gentry, T. C Krejcie, T. K Henthorn, C. A. Shanks, K. A. Howard, D. K. Gupta, M. J. Avram. Effect of infusion rate on thiopental dose-response relationships. Assessment of a pharmacokinetic-pharmacodynamic model. Anesthesiology 81, 316–24 (1994).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Mortier, E.P., Struys, M.M.R.F. (2003). Effect Site Modelling and Its Application in TCI. In: Vuyk, J., Schraag, S. (eds) Advances in Modelling and Clinical Application of Intravenous Anaesthesia. Advances in Experimental Medicine and Biology, vol 523. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-9192-8_21
Download citation
DOI: https://doi.org/10.1007/978-1-4419-9192-8_21
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-4830-6
Online ISBN: 978-1-4419-9192-8
eBook Packages: Springer Book Archive