Predictive performance of computer-controlled infusion of remifentanil during propofol/remifentanil anaesthesia M.J. Mertens, F.H.M. Engbers, A.G.L.

Slides:

Advertisements

Similar presentations

Relationship between Bispectral Index, electroencephalographic state entropy and effect-site EC50 for propofol at different clinical endpoints M. Iannuzzi,

Advertisements

Predictive performance of eleven pharmacokinetic models for propofol infusion in children for long-duration anaesthesia M Hara, K Masui, D.J. Eleveld,

Pharmacokinetic parameter sets of alfentanil revisited: optimal parameters for use in target controlled infusion and anaesthesia display systems N Sigmond,

C Dualé, C Frey, F Bolandard, A Barrière, P Schoeffler

M. M. Sahinovic, D. J. Eleveld, T Miyabe-Nishiwaki, M. M. R. F

AnestAssist British Journal of Anaesthesia

Reduced clearance of rocuronium and sugammadex in patients with severe to end- stage renal failure: a pharmacokinetic study† L.M. Staals, M.M.J. Snoeck,

Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol–remifentanil total i.v. anaesthesia with desflurane anaesthesia

Problems in obtaining sufficient anaesthesia with propofol and remifentanil: three cases, a test infusion, and a review S. Bache, L. Stendell, N.V. Olsen,

Pharmacokinetic/pharmacodynamic model for unfractionated heparin dosing during cardiopulmonary bypass X. Delavenne, E. Ollier, S. Chollet, F. Sandri,

A.R. Absalom, V. Mani, T. De Smet, M.M.R. F. Struys

Changes in the effect of propofol in response to altered plasma protein binding during normothermic cardiopulmonary bypass E Takizawa, H Hiraoka, D Takizawa,

Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state P.S.

J. Ahonen, R. Jokela, K. Uutela, M. Huiku

Capnogram slope and ventilation dead space parameters: comparison of mainstream and sidestream techniques A.L. Balogh, F. Petak, G.H. Fodor, J. Tolnai,

J.-Y. Hwang, H.-S. Na, Y.-T. Jeon, Y.-J. Ro, C.-S. Kim, S.-H. Do

Pharmacokinetics of intravenous emulsified isoflurane in beagle dogs

Pharmacokinetics of intranasal fentanyl in parturient

S. Kreuer, J. Bruhn, R. Larsen, M. Hoepstein, W. Wilhelm

Bispectral index, serum drug concentrations and emergence associated with individually adjusted target-controlled infusions of remifentanil and propofol.

Pharmacodynamic modelling of the bispectral index response to propofol-based anaesthesia during general surgery in children C. Jeleazcov, H. Ihmsen,

Behaviour of spectral entropy, spectral edge frequency 90%, and alpha and beta power parameters during low-dose propofol infusion P. Mahon, B.R. Greene,

Remifentanil–midazolam sedation for paediatric patients receiving mechanical ventilation after cardiac surgery† A.E. Rigby-Jones, M.J. Priston, J.R.

Comparison of remifentanil and alfentanil during anaesthesia for patients undergoing direct laryngoscopy without intubation E. Wiel, M. Davette, L. Carpentier,

M.A. Olympio, R. Whelan, R.P.A. Ford, I.C.M. Saunders

Preoperative supplementation with fibrinogen concentrate in cardiac surgery: A randomized controlled study A. Jeppsson, K. Waldén, C. Roman-Emanuel,

A. J. Cronin, N. M. Aucutt-Walter, T Budinetz, C. P. Bonafide, N. A

A. Absalom, D. Amutike, A. Lal, M. White, G.N.C. Kenny

Complete heart block during central venous catheter placement in a patient with pre- existing left bundle branch block D Unnikrishnan, N Idris, N Varshneya

Spectral entropy measurement of patient responsiveness during propofol and remifentanil. A comparison with the bispectral index† Vanluchene A.L.G. ,

Population pharmacokinetics of nalbuphine after surgery in children

J.B. Whiteside, D Burke, J.A.W. Wildsmith

Detection of awareness in surgical patients with EEG-based indices—bispectral index and patient state index†‡ G. Schneider, A.W. Gelb, B. Schmeller,

Effect of continuous low-dose intravenous diltiazem on epidural fentanyl analgesia after lower abdominal surgery K. Nitahara, M. Matsunaga, K. Katori,

EEG-controlled closed-loop dosing of propofol in rats

B. Allaouchiche, F. Duflo, J.-P. Tournadre, R. Debon, D. Chassard

Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol–remifentanil anaesthesia M. Gruenewald, C. Ilies, J. Herz,

Expertise in practice: an ethnographic study exploring acquisition and use of knowledge in anaesthesia A. Smith, D. Goodwin, M. Mort, C. Pope British.

Bispectral analysis of the electroencephalogram does not predict responsiveness to verbal command in patients emerging from xenon anaesthesia† T. Goto,

Pharmacodynamic response modelling of arterial blood pressure in adult volunteers during propofol anaesthesia C. Jeleazcov, M. Lavielle, J. Schüttler,

Remifentanil target-controlled infusion vs propofol target-controlled infusion for conscious sedation for awake fibreoptic intubation: a double-blinded.

Dolasetron prophylaxis reduces nausea and postanaesthesia recovery time after remifentanil infusion during monitored anaesthesia care for extracorporeal.

V. Uppal, G. Fletcher, J. Kinsella British Journal of Anaesthesia

H. Beloeil, J.-X. Mazoit, D. Benhamou, J. Duranteau

Bispectral index is related to the spread of spinal sensory block in patients with combined spinal and general anaesthesia R Iida, K Iwasaki, J Kato,

Predictive performance of ‘Servin's formula’ during BIS®-guided propofol-remifentanil target-controlled infusion in morbidly obese patients A. Albertin,

Anaesthesia for awake craniotomy—evolution of a technique that facilitates awake neurological testing A. Sarang, J. Dinsmore British Journal of Anaesthesia

Accuracy of feedback-controlled oxygen delivery into a closed anaesthesia circuit for measurement of oxygen consumption† A.W. Schindler, T.W.L. Scheeren,

Predictive performance of the modified Marsh and Schnider models for propofol in underweight patients undergoing general anaesthesia using target-controlled.

Comparison of 1% and 2% lidocaine epidural anaesthesia combined with sevoflurane general anaesthesia utilizing a constant bispectral index A Shono, S.

Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium A.B. Chiarella, D.T. Jolly, C.M. Huston, A.S.

Do old pharmacokinetic parameter estimates predict new data?

Spinal anaesthesia: a comparison of plain ropivacaine 5 mg ml−1 with bupivacaine 5 mg ml−1 for major orthopaedic surgery T.M. Cook, D.A. McNamee, K.R.

F.H. Engbers, N Sutcliffe, G Kenny, S Schraag

J.H.P. Friesen British Journal of Anaesthesia

Effects of different remifentanil target concentrations on MAC BAR of sevoflurane in gynaecological patients with CO2 pneumoperitoneum stimulus Z.-Y.

Anticoagulation monitoring during vascular surgery: accuracy of the Hemochron® low range activated clotting time (ACT-LR) B. Tremey, B. Szekely, S. Schlumberger,

Rare event research: is it worth it?

Stress response during weaning after cardiac surgery

Comparison of ropivacaine 0. 5% (in glucose 5%) with bupivacaine 0

A randomized trial of the effect of low dose epinephrine infusion in addition to tranexamic acid on blood loss during total hip arthroplasty Ø. Jans,

Fibrinogen plasma concentration before delivery is not associated with postpartum haemorrhage: a prospective observational study O. Karlsson, A. Jeppsson,

Effect of age on the clinical profile and systemic absorption and disposition of levobupivacaine after epidural administration Simon M.J.G. , Veering.

Nitrous oxide does not produce a clinically important sparing effect during closed-loop delivered propofol–remifentanil anaesthesia guided by the bispectral.

Rocuronium dose-dependently suppresses the spectral entropy response to tracheal intubation during propofol anaesthesia M. Kawaguchi, I. Takamatsu, T.

Controlled hypotension for middle ear surgery: a comparison between remifentanil and magnesium sulphate† J.-H. Ryu, I.-S. Sohn, S.-H. Do British Journal.

Relationship between Bispectral Index, electroencephalographic state entropy and effect-site EC50 for propofol at different clinical endpoints M. Iannuzzi,

Monitoring level of sedation with bispectral EEG analysis: comparison between hypothermic and normothermic cardiopulmonary bypass† D. Schmidlin, P. Hager,

Closed-loop control of propofol anaesthesia using bispectral index™: performance assessment in patients receiving computer-controlled propofol and manually.

Effects of dexmedetomidine on adrenocortical function, and the cardiovascular, endocrine and inflammatory responses in post-operative patients needing.

Presentation transcript:

Predictive performance of computer-controlled infusion of remifentanil during propofol/remifentanil anaesthesia M.J. Mertens, F.H.M. Engbers, A.G.L. Burm, J. Vuyk British Journal of Anaesthesia Volume 90, Issue 2, Pages 132-141 (February 2003) DOI: 10.1093/bja/aeg046 Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 1 Flow chart describing the methods used in the study. British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 2 (Left panels) Regression analysis (dashed lines) of predicted (Cp) vs measured (Cm) blood concentrations of remifentanil. Thick lines indicate identity. (Right panels) Plots of remifentanil performance error in relation to the predicted blood concentration of remifentanil. Thin lines indicate median performance error (MDPE) and the interquartile range of the MDPE. Predicted blood concentrations of remifentanil were calculated using the remifentanil pharmacokinetic parameters set of Minto and colleagues1 (upper panel: Cm=0.76Cp+0.36; r=0.93), Egan and colleagues2 (middle panel: Cm=0.86Cp+0.42;r=0.91) and Egan and collaegues3 (lower panel: Cm=0.86Cp+0.35; r=0.92). British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 3 (Left panels) Regression analysis (dashed lines) of predicted (Cp) vs measured (Cm) blood concentration of remifentanil. Thick lines indicate identity. (Right panels) Plot of the remifentanil performance error in relation to predicted blood concentration of remifentanil. Thin lines indicate the median performance error (MDPE) and the interquartile range of the MDPE. Predicted blood concentrations of remifentanil were calculated using the remifentanil pharmacokinetic parameters set of Egan and collaegues4 (upper panel: Cm=0.79Cp+0.47; r=0.92) and Drover and Lemmens5 (lower panel: Cm=0.64Cp+0.45; r=0.93). British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 4 Percentage performance error vs time for all 30 patients. Predicted blood concentrations of remifentanil were calculated using the remifentanil pharmacokinetic parameter set of Minto and colleagues1 (upper left), Egan and colleagues2 (upper right), Egan and colleagues3 (middle left), Egan and collaegues4 (middle right) and Drover and Lemmens5 (lower left). The dashed lines indicate the median performance error (MDPE) and its interquartile range. Most of the very high performance errors are a result of misprediction of very low measured blood concentrations of remifentanil (0.1–0.2 ng ml−1) and thus lack clinical significance. British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 5 Median performance error (upper left), median absolute performance error (upper right), divergence (lower left) and wobble (lower right) for all 30 patients. The pharmacokinetic parameter set used to calculate the predicted blood remifentanil concentrations is indicated below the x-axis. British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 6 Regression analysis (line) of measured blood propofol concentration (Cprop) vs the remifentanil performance error (PErem). Thin lines indicate the median performance error (MDPE) and its interquartile range. Remifentanil performance errors were calculated using the remifentanil pharmacokinetic parameters set of Minto and colleagues1 (PErem=3.16Cprop–18.4; R2=0.02). British Journal of Anaesthesia 2003 90, 132-141DOI: (10.1093/bja/aeg046) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions