General kinetic and dynamic principles and their application to continuous infusion anaesthesia

Area of Science:

• Pharmacokinetics
• Anaesthesiology
• Intravenous drug administration

Background:

• Continuous infusions of intravenous anaesthetic agents are common in clinical practice.
• Effective use necessitates a thorough understanding of drug pharmacokinetics.
• Knowledge gaps can lead to suboptimal patient outcomes.

Purpose of the Study:

• To present the general pharmacokinetic principles relevant to intravenous anaesthetic infusions.
• To review the existing literature on the pharmacokinetic properties of commonly used intravenous anaesthetic agents administered via continuous infusion.
• To provide a comprehensive resource for clinicians managing anaesthesia with continuous infusions.

Main Methods:

• Review of pharmacokinetic principles applicable to continuous infusions.
• Systematic literature search for studies on intravenous anaesthetic agents used in continuous infusions.
• Synthesis of pharmacokinetic data including absorption, distribution, metabolism, and excretion.

Main Results:

• General pharmacokinetic principles such as steady-state concentration, drug accumulation, and context-sensitive half-time are discussed.
• Pharmacokinetic profiles of key anaesthetic agents (e.g., propofol, remifentanil) are detailed.
• Variability in patient factors affecting drug disposition is highlighted.

Conclusions:

• A strong grasp of pharmacokinetic principles is essential for optimizing intravenous anaesthetic infusions.
• Understanding individual drug properties allows for precise dose adjustments and improved patient safety.
• This review serves as a guide for evidence-based anaesthetic practice using continuous infusions.