Mixed-effects modeling of the influence of alfentanil on propofol pharmacokinetics

被引:55
作者
Mertens, MJ [1 ]
Olofsen, E [1 ]
Burm, AGL [1 ]
Bovill, JG [1 ]
Vuyk, J [1 ]
机构
[1] Leiden Univ, Dept Anesthesiol, Med Ctr, NL-2300 RC Leiden, Netherlands
关键词
D O I
10.1097/00000542-200404000-00008
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: The influence of alfentanil on the pharmacokinetics of propofol is poorly understood. Therefore, the authors studied the effect of a pseudo-steady state concentration of alfentanil on the pharmacokinetics of propofol. Methods: The pharmacokinetics of propofol were studied on two occasions in eight male volunteers in a randomized crossover. manner with a 3-week interval. While volunteers breathed 30% O-2 in air, 1 mg/kg intravenous propofol. was given in 1 min, followed by 3 mg (.) kg(-1) (.) h(-1) for 59 min (sessions A and B). During session B, a target-controlled infusion of alfentanil (target concentration, 80 ng/ml) was given from 10 min before the start until 6 h after termination of the propofol infusion. Blood pressure, cardiac output, electrocardiogram, respiratory rate, oxygen saturation, and end-tidal carbon dioxide were monitored. Venous blood samples for determination of the blood propofol and plasma alfentanil concentration were collected until 6 h after termination of the propofol infusion. Nonlinear mixed-effects population pharmacokinetic models examining the influence of alfentanil and hemodynamic parameters on propofol pharmacokinetics were constructed. Results: A two-compartment model, including a lag time accounting for the venous blood sampling, adequately described the concentration-time curves of propofol. Alfentanil decreased the elimination clearance of propofol from 2.1 l/min to 1.9 l/min, the distribution clearance from 2.7 l/min to 2.0 l/min, and the peripheral volume of distribution from 179 l to 141 l. Scaling the pharmacokinetic parameters to cardiac output, heart rate, and plasma alfentanil concentration significantly improved the model. Conclusions: Alfentanil alters the pharmacokinetics of propofol. Cardiac output and heart rate have an important influence on the pharmacokinetics of propofol.
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页码:795 / 805
页数:11
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