[Pharmacokinetic evaluation of a computerized target-controlled infusion system: application to propofol in orthopedic surgery].

P Aouizerate, L Dumé, D Bouleau, P Duvaldestin, A Astier
Author Information
  1. P Aouizerate: Service de Pharmacie du Centre Hospitalier de Meaux, France.

Abstract

PaMo 2.0, a type of software, includes a pharmacokinetic model for propofol in the adult. It allows both administration and monitoring of propofol target-controlled infusions. In order to evaluate PaMo 2.0, a prospective clinical trial compared, at defined infusion times, predicted and measured plasma propofol concentrations, in 28 patients programmed for hip-replacement surgery. A propofol plasma determination technique had first been validated, including high performance liquid chromatography with fluorescence detection. A statistical analysis based on correlation (r = 0.73), inaccuracy = 29.18 per cent, bias = 11.67 per cent, wobble = 19.15 per cent, and divergence = -0.06 per cent/min calculation, related to this system, has been carried out. PaMo 2.0 under-estimated plasma propofol concentrations. The convergence between predicted and measured propofol concentrations was good and not modified in respect of infusion time. This infusion system is suitable for propofol administration, but the integration of Bayesian pharmacokinetic models would greatly improve propofol plasma concentration estimation and regimen adaptation to each patient.

MeSH Term

Adult
Aged
Aged, 80 and over
Anesthesia, Intravenous
Anesthetics, Intravenous
Arthroplasty, Replacement, Hip
Humans
Middle Aged
Propofol
Prospective Studies
Software

Chemicals

Anesthetics, Intravenous
Propofol

Word Cloud

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