Related Experiment Video
Updated: Aug 4, 2026
08:49
Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
Influence of Bayesian optimization on the performance of propofol target-controlled infusion
J P van den Berg1, D J Eleveld1, T De Smet2
1Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
British Journal of Anaesthesia
|October 14, 2017
Summary
Personalized propofol titration using Bayesian adaptation improved bias in target-controlled infusion (TCI) systems but did not enhance precision. This approach optimizes drug delivery by accounting for individual patient variations in pharmacokinetic models.
Area of Science:
- Anesthesiology and Pharmacology
- Pharmacokinetics and Pharmacodynamics
- Medical Device Technology
Background:
- Target-controlled infusion (TCI) systems rely on population pharmacokinetic (PK) models, which do not account for individual patient variability.
- Inter-individual variation in PK models can lead to suboptimal drug dosing and patient outcomes.
- This study investigates the impact of Bayesian adaptation for personalized TCI propofol titration.
Purpose of the Study:
- To compare the bias and inaccuracy of population-based versus personalized TCI propofol titration using Bayesian adaptation.
- To evaluate hemodynamic and hypnotic stability during anesthesia.
- To assess the prediction probability of alternative propofol PK models.
Main Methods:
- A double-blinded, prospective randomized controlled trial involving 120 cardiac surgery patients.
- Blood samples analyzed using a point-of-care propofol blood analyzer.
- Bayesian adaptation of the PK model applied at 60 minutes in the intervention group; Median (Absolute) Performance Error (Md(A)PE) used for evaluation.
Main Results:
- No significant difference in MdPE or MdAPE between groups during the pre-adjustment period.
- Post-adjustment, MdPE differed significantly (-0.3% vs. 12%), while MdAPE did not (15% vs. 18%).
- The Eleveld propofol PK model demonstrated the best prediction performance among the models studied.
Conclusions:
- Bayesian adaptation of an accurate population-based PK model for propofol TCI improved bias.
- Precision was not significantly improved by Bayesian adaptation.
- No significant differences in hemodynamic (MAP, heart rate) or hypnotic (BIS) stability were observed between groups.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:15Factors Affecting Drug Distribution: Organ Perfusion Rate
Drug distribution within the body is a complex process influenced by several factors, including perfusion rate, the rate at which the bloodstream transports drugs to tissue. This limitation becomes particularly significant when dealing with highly lipophilic drugs. In such cases, the rate at which the drug can move across membranes is crucial, and if the membrane is highly permeable to the drug, distribution becomes rate-limited by perfusion.
Perfusion rate-limited distribution relies on the...
Perfusion rate-limited distribution relies on the...
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
00:56One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance
Clearance is a key pharmacokinetic parameter that quantifies the volume of body fluid from which a drug is entirely removed within a specific time frame. It is crucial in assessing how a drug is eliminated from the body and has critical clinical applications.
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
01:15Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions
PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure (CHF).