A novel technique to determine an ‘apparent ke0’ value for use with the Marsh pharmacokinetic model for propofol

Summary Debate continues over the most appropriate blood–brain equilibration rate constant (ke0) for use with the Marsh pharmacokinetic model for propofol. We aimed to define the optimal ke0 value. Sixty‐four patients were sedated with incremental increases in effect‐site target concentration of pro...

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Bibliographic Details
Published in:Anaesthesia 2014-05, Vol.69 (5), p.420-428
Main Authors: Thomson, A. J., Nimmo, A. F., Engbers, F. H. M., Glen, J. B.
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia
Anesthetics, Intravenous - pharmacokinetics
Female
Humans
Male
Middle Aged
Models, Biological
Pharmacology
Propofol - pharmacokinetics
Young Adult
Online Access:Get full text
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Summary:Summary Debate continues over the most appropriate blood–brain equilibration rate constant (ke0) for use with the Marsh pharmacokinetic model for propofol. We aimed to define the optimal ke0 value. Sixty‐four patients were sedated with incremental increases in effect‐site target concentration of propofol while using six different ke0 values within the range 0.2–1.2 min−1. Depth of sedation was assessed by measuring visual reaction time. A median ‘apparent ke0’ value of 0.61 min−1 (95% CI 0.37–0.78 min–1) led to the greatest probability of achieving a stable clinical effect when the effect‐site target was fixed at the effect‐site concentration displayed by the target‐controlled infusion system, at the time when a desired depth of sedation had been reached. By utilising a clinically relevant endpoint to derive this value, inter‐individual pharmacokinetic and pharmacodynamic variability may be accounted for.
ISSN:0003-2409
1365-2044
DOI:10.1111/anae.12596