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Acceptance of a propofol and remifentanil infusion dosing algorithm to optimize postoperative emergence and analgesia

  • Carl TamsEmail author
  • Ken Johnson
  • Christoph Seubert
Original Research
  • 12 Downloads

Abstract

We implemented a pharmacokinetic/pharmacodynamic (PK/PD) based optimization algorithm recommending intraoperative Remifentanil and Propofol infusion rates to minimize time to emergence and maximize the duration of analgesia in a clinical setting. This feasibility study tested the clinical acceptance of the optimization algorithm’s recommendations during scoliosis surgical repair for 14 patients. Anesthesiologist accepted 359/394 (91%) of the recommendations given on the basis of the optimization algorithm. While following the optimization’s recommendations the anesthesiologist decreased Propofol infusions from an average of 164–135 mcg/kg/min [p = 0.002] and increased Remifentanil infusions from an average of 0.22–0.30 mcg/kg/min [p = 0.004]. The anesthesiologists appeared to accept and follow the recommendations from a PK/PD based optimization algorithm.

Keywords

Anesthesia Pharmacokinetic Pharmacodynamic Total intravenous anesthesia Optimization Idiopathic scoliosis 

Notes

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of UtahSalt Lake CityUSA
  2. 2.Department of AnesthesiologyUniversity of FloridaGainesvilleUSA

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