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External Validation of a Pharmacokinetic Model of Propofol for Target-Controlled Infusion in Children under Two Years

Sang Hwan Ji1, Ji Hyun Lee1, Joo Youn Cho2

  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

Journal of Korean Medical Science
|March 21, 2020
PubMed

Insights

The Kim model for propofol and remifentanil infusion is applicable to children under two years old. External validation confirmed its clinical acceptability for target-controlled infusions in this young population.

Area of Science:

  • Anesthesiology and Pharmacology
  • Pediatric Pharmacokinetics

Background:

  • Limited pharmacokinetic-pharmacodynamic models exist for propofol in children under two years old.
  • The Kim model, previously developed for children aged 2-12 years, required validation for younger pediatric populations.

Purpose of the Study:

  • To externally validate the applicability of the Kim model for propofol and remifentanil target-controlled infusions in children younger than two years.
  • To assess the clinical acceptability of the Kim model's pharmacokinetic predictions in this age group.

Main Methods:

  • Twenty-four children under two years received propofol and remifentanil infusions guided by the Kim model.
  • Plasma concentrations were sampled at target propofol effect-site concentrations (2-5 μg/mL) to evaluate model performance using bias, inaccuracy, divergence, and wobble.

Main Results:

  • Ninety-five plasma concentrations were analyzed for model evaluation.
  • The population estimate for bias was -0.96% and for inaccuracy was 21.0% for propofol plasma concentrations.

Conclusions:

  • The Kim model demonstrates clinically acceptable bias and inaccuracy for pharmacokinetic predictions in children under two years.
  • The model is applicable for target-controlled infusion of propofol in this pediatric population, with recommended bispectral index monitoring when remifentanil is co-administered.
Abstract

Keywords:
AnesthesiologyModeling & SimulationPediatricsPopulation Pharmacokinetics

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