Revista de sistemas biomédicos y tecnologías emergentes

Comparison of Pharmacokinetic Models for Hypnosis Control Based on Effect-Site Propofol Concentration to Maintain Appropriate Hypnosis

Abstract

Eiko Furutani*,Chie Sakai,Toshihiro Takeda,Gotaro Shirakami

This paper studies an appropriate pharmacokinetic (PK) model for hypnosis control based on effect-site anesthetic concentration. For maintaining hypnosis, methods to keep plasma or effect-site concentration of propofol, an anesthetic drug, calculated using PK models at a target level are often used. In order to realize a desirable hypnosis control by such methods an accurate estimation of propofol concentration corresponding to the threshold of unconsciousness is critical. Since time variation of the calculated propofol concentration depends on the PK model, the performance of maintaining hypnosis also depends on it. In this paper, we compare the existing PK models of propofol focusing on sensitivity and specificity for detecting consciousness during anesthesia by a criterion based on cal ulated propofol concentration and measured aepEX, a hypnosis index. The results show that Barr model provides the highest sensitivity and specificity, and that Marsh, modified Marsh, and Schnider models, which are often used in target controlled infusion systems give fairly high sensitivity and specificity.