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While propofol pharmacokinetics (PK) are widely studied, there is a relative paucity of pharmacodynamic data. Propofol is frequently used for induction and maintenance of anesthesia in adults and children, as it has desirable pharmacokinetic and pharmacodynamic properties. This may imply that BIS and cAAI measure fundamentally different endpoints in the brain. Large differences were demonstrated between both monitors. ConclusionsĪ population PKPD model for propofol in adolescents was developed that successfully described the time course of propofol concentration, BIS and cAAI in individuals upon undergoing scoliosis surgery with intraoperative wake-up test and reinduction of anesthesia. The delay in PD effect in relation to plasma concentration was best described by a two compartment effect-site model with a ke o of 0.102 min − 1, ke 12 of 0.121 min − 1 and ke 21 of 0.172 min − 1. For the sigmoidal Emax model, the propofol concentration at half maximum effect (EC 50) was 3.51 and 2.14 mg/L and Hill coefficient 1.43 and 6.85 for BIS and cAAI, respectively.
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The time courses of propofol concentrations, BIS and cAAI values during anesthesia, intra-operative wakeup and reduction of anesthesia were best described by a two-compartment PK model linked to an inhibitory sigmoidal Emax PD model. A propofol PKPD model was developed using NONMEM. BIS and cAAI were continuously measured and blood samples collected. Methodsįourteen adolescents (9.8–20.1 years) were evaluated during standardized propofol-remifentanil anesthesia for idiopathic scoliosis surgery with an intraoperative wake-up test with reinduction of anesthesia. In this study we derived a PK-PD model for propofol in adolescents undergoing idiopathic scoliosis surgery with an intraoperative wake-up test with reinduction of anesthesia using both Bispectral Index (BIS) and composite A-line ARX index (cAAI) as endpoints. In adolescents limited data are available on the pharmacokinetics (PK) and pharmacodynamics (PD) of propofol.