Propofol pharmacokinetic and pharmacodynamic profile and its electroencephalographic interaction with remifentanil in children

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dc.catalogadorvdr
dc.contributor.authorFuentes HenrÍquez, Ricardo Sergio
dc.contributor.authorCortínez Fernández, Luis Ignacio
dc.contributor.authorContreras Ibacache, Víctor
dc.contributor.authorIbacache Figueroa, Mauricio Enrique
dc.date.accessioned2025-07-04T14:52:56Z
dc.date.available2025-07-04T14:52:56Z
dc.date.issued2018
dc.description.abstractBackground: Propofol and remifentanil are commonly combined during total intravenous anesthesia. The impact of remifentanil in this relationship is poorly quantified in children. Derivation of an integrated pharmacokinetic and pharmacodynamic propofol model, containing remifentanil pharmacodynamic interaction information, enables propofol effect-site target-controlled infusion in children with a better prediction of its hypnotic effect when both drugs are combined.||Aims: We designed this study to derive an integrated propofol pharmacokinetic-pharmacodynamic model in children and to describe the pharmacodynamic interaction between propofol and remifentanil on the electroencephalographic bispectral index effect.||Methods: Thirty children (mean age: 5.45 years, range 1.3-11.9; mean weight: 23.5 kg, range 8.5-61) scheduled for elective surgery with general anesthesia were studied. After sevoflurane induction, maintenance of anesthesia was based on propofol and remifentanil. Blood samples to measure propofol concentration were collected during anesthesia maintenance and up to 6 hours in the postoperative period. Bispectral index data were continuously recorded throughout the study. A pharmacokinetic-pharmacodynamic model was developed using population modeling. The Greco model was used to examine the pharmacokinetic-pharmacodynamic interaction between propofol and remifentanil for BIS response||Results: Propofol pharmacokinetic data from a previous study in 53 children were pooled with current data and simultaneously analyzed. Propofol pharmacokinetics were adequately described by a three-compartment distribution model with first-order elimination. Theory-based allometric relationships based on TBW improved the model fit. The Greco model supported an additive interaction between propofol and remifentanil. Remifentanil showed only a minor effect in BIS response.||Conclusion: We have developed an integrated propofol pharmacokinetic-pharmacodynamic model that can describe the pharmacodynamic interaction between propofol and remifentanil for BIS response. An additive interaction was supported by our modeling analysis.
dc.description.abstractCortínez Fernández, Luis Ignacio
dc.fechaingreso.objetodigitalNo aplica
dc.fuente.origenORCID
dc.identifier.doi10.1111/pan.13486
dc.identifier.eissn1460-9592
dc.identifier.issn1155-5645
dc.identifier.urihttps://doi.org/10.1111/pan.13486
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104854
dc.identifier.wosidWOS:000453482100003
dc.information.autorucEscuela de Medicina; Fuentes HenrÍquez, Ricardo Sergio; S/I; 91662
dc.information.autorucEscuela de Medicina; Cortínez Fernández, Luis Ignacio; S/I; 79356
dc.information.autorucEscuela de Medicina; Contreras Ibacache, Víctor; S/I; 101258
dc.information.autorucEscuela de Medicina; Ibacache Figueroa Mauricio Enrique; S/I; 817
dc.issue.numero12
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final1086
dc.pagina.inicio1078
dc.revistaPediatric Anesthesia
dc.rightsacceso restringido
dc.titlePropofol pharmacokinetic and pharmacodynamic profile and its electroencephalographic interaction with remifentanil in children
dc.typeartículo
dc.volumen28
sipa.codpersvinculados91662
sipa.codpersvinculados79356
sipa.codpersvinculados101258
sipa.codpersvinculados817
sipa.trazabilidadORCID;20-07-2021
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