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Response surface modelling of the pharmacodynamic interaction between propofol and remifentanil in patients undergoing anaesthesia

Title
Response surface modelling of the pharmacodynamic interaction between propofol and remifentanil in patients undergoing anaesthesia
Authors
Choe, SangMinChoi, Byung-MoonLee, Yong-HunLee, Soo-HanLee, Eun-KyungKim, Ki-SeongNoh, Gyu-Jeong
Ewha Authors
이은경
SCOPUS Author ID
이은경scopus
Issue Date
2017
Journal Title
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY
ISSN
1440-1681JCR Link
Citation
vol. 44, no. 1, pp. 30 - 40
Keywords
interactionpropofolremifentanil
Publisher
WILEY-BLACKWELL
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
This study describes the pharmacodynamic interaction between propofol and remifentanil. Sixty patients who were scheduled for elective surgery under general anaesthesia (30 males/30 females) were enrolled. Patients were randomly allocated to receive one of 15 combinations of drug levels. Baseline electroencephalograms (EEGs) were recorded for 5minutes prior to administering the drugs. Patients received a target-controlled infusion at one of four predefined doses of propofol (high, 3g/mL; medium, 1.5g/mL; low, 0.5g/mL; or no drug) and of remifentanil (high, 6 or 8ng/mL; medium, 4ng/mL; low, 2ng/mL; or no drug). The occurrence of muscle rigidity, apnoea, and loss of consciousness (LOC) was monitored, and EEGs were recorded during the drug administration phase. Electroencephalographic approximate entropy (ApEn) and temporal linear mode complexity (TLMC) parameters at baseline and under steady state conditions were calculated off-line. Response surfaces were developed to map the interaction between propofol and remifentanil to the probability of occurrence for quantal responses (muscle rigidity, apnoea, LOC) and ApEn and TLMC measurements. Model parameters were estimated using non-linear mixed effects modelling. The response surface revealed infra-additive and synergistic effects for muscle rigidity and apnoea, respectively. The effects of the combined drugs on LOC and EEG parameters (eg, ApEn and TLMC) were additive. The C-50 estimates of remifentanil (ng/mL) and propofol (g/mL) were 9.11 and 130000 for muscle rigidity, 8.99 and 6.26 for apnoea, 13.9 and 3.04 for LOC, 23.4 and 10.4 for ApEn, and 14.8 and 6.51 for TLMC, respectively. The probability of occurrence for muscle rigidity declined when propofol was combined with remifentanil.
DOI
10.1111/1440-1681.12677
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자연과학대학 > 통계학전공 > Journal papers
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