目标控制输注普罗波:对最近的结果进行系统审查
Pavla Šafránková1, Jan Bruthans2,3
1Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, Kladno, CZ-272 01, Czech Republic.
Journal of medical systems
|April 27, 2025
概括
本综述评估了用于目标控制输液 (TCI) 麻醉的propofol药理动力学-药理动力学 (PK-PD) 模型. 目前的模型显示了可变的准确性,突出了提高剂量精度和个性化麻醉管理的需要.
科学领域:
- 麻醉学 麻醉学
- 药理动力学 药理动力学
- 药理动力学是什么 药理动力学
背景情况:
- 目标控制输注 (TCI) 对于在麻醉中给予普罗波非常重要.
- 准确的药理动力学-药理动力学 (PK-PD) 模型对于安全有效的TCI至关重要.
- 现有的模型在不同患者群体的预测性能上有所不同.
研究的目的:
- 系统地审查和评估PK-PD模型的propofol TCI.
- 为了比较现有模型的性能,并评估新的模型开发.
- 确定在麻醉中精确剂量测定方面的挑战和未来方向.
主要方法:
- 按照PRISMA 2020指南进行系统审查.
- 在主要的科学数据库 (PubMed,Scopus,Web of Science等) 中进行全面的文献搜索. ) 的情况.
- 包括标准适用于427个已识别的来源,其中17项研究符合分析要求.
主要成果:
- 对Eleveld,Marsh和Schnider模型的比较分析显示了不同的预测准确度.
- 施奈德模型在老年患者中显示出更好的偏差控制; 埃莱维尔德模型改善了肥胖患者的清除.
- 在预测普罗波福尔脑度方面仍然存在不一致;新的模型需要外部验证.
结论:
- 没有一个单一的PK-PD模型在所有患者人口统计学中普遍优于其他模型.
- 需要进一步的研究来完善TCI模型,使其具有普遍适用性和个性化麻醉.
- 适应剂量策略的开发和机器学习集成显示了精确剂量的前景.
相关概念视频
Parenteral Anesthetics: Overview
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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.
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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,...
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Drug Delivery: Parenteral Route
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The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
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Inhalational Anesthetics: Overview
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
159


