Modeling the pharmacokinetics and pharmacodynamics of sevoflurane using compartment models in children and adults.

Show simple item record Cortínez, Luis Ignacio en Anderson, Brian en 2019-03-08T02:27:46Z en 2018-10 en
dc.identifier.issn 1155-5645 en
dc.identifier.uri en
dc.description.abstract BACKGROUND:Sevoflurane pharmacokinetics have been traditionally described using physiological models, while pharmacodynamics employed the use of minimal alveolar concentration. AIMS:The integrated pharmacokinetic-pharmacodynamic relationship of sevoflurane in both adults and children was reviewed using compartment models. We wished to delineate age-related changes in both pharmacokinetics and pharmacodynamics. METHODS:The bispectral index and sevoflurane endtidal concentration were continuously measured in 50 patients, aged 3-71 years, scheduled for minor surgery. During maintenance of anesthesia and after stable bispectral index values of 60-65 were obtained, the inspired concentration of sevoflurane was increased to 5 vol % for 5 minutes or until BIS 40 and then decreased. Data were analyzed using mammillary compartments with nonlinear mixed effects population modeling. The covariate effects of age and size were investigated. RESULTS:A three-compartment PK model adequately described sevoflurane pharmacokinetics. Size standardization using allometry explained clearance and volume changes with age. The equilibration half-time (1.48 minutes) increased with age, but could be predicted using allometry in those under 40 years. The effect site concentration eliciting half the maximum response at age 40 years was 1.3% (95%CI 1.22, 1.42) decreased with age from 1.6% at 3 years to 1.1% at 70 years. CONCLUSION:Pharmacokinetic compartment models offer an alternative method to describe inhalation anesthetic drug disposition and effects. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Paediatric anaesthesia en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.subject Humans en
dc.subject Propofol en
dc.subject Anesthetics, Inhalation en
dc.subject Electroencephalography en
dc.subject Anesthesia en
dc.subject Age Factors en
dc.subject Models, Biological en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Middle Aged en
dc.subject Child en
dc.subject Child, Preschool en
dc.subject Female en
dc.subject Male en
dc.subject Young Adult en
dc.subject Consciousness Monitors en
dc.subject Sevoflurane en
dc.title Modeling the pharmacokinetics and pharmacodynamics of sevoflurane using compartment models in children and adults. en
dc.type Journal Article en
dc.identifier.doi 10.1111/pan.13465 en
pubs.issue 10 en
pubs.begin-page 834 en
pubs.volume 28 en
dc.rights.holder Copyright: The author en
pubs.end-page 840 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.elements-id 751939 en Medical and Health Sciences en School of Medicine en Anaesthesiology en
dc.identifier.eissn 1460-9592 en
pubs.record-created-at-source-date 2018-08-18 en
pubs.dimensions-id 30117213 en

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