Sevoflurane Remifentanil Interaction

• DOI: 10.1097/aln.0b013e318242a2ec
• Publication Date: 2012-01-06T14:28:05Z
• Authors: Bjorn Heyse; Johannes H. Proost; Peter M. Schumacher; Thomas W. Bouillon; Hugo E. M. Vereecke; Douglas J. Eleveld; Martin Luginbühl; Michel M. R. F. S...
• Keywords: NONMEM; Pharmacodynamics

Background Various pharmacodynamic response surface models have been developed to quantitatively describe the relationship between two or more drug concentrations with their combined clinical effect. We examined interaction of remifentanil and sevoflurane on probability tolerance shake shout, tetanic stimulation, laryngeal mask airway insertion, laryngoscopy in patients compare performance five different models. Methods Forty preoperatively received (0-12 ng/ml) (0.5-3.5 vol.%) according a criss-cross design (160 concentration pairs, four per patient). After having reached pseudosteady state, was recorded. For analysis tolerance, were tested: Greco, Reduced Minto, Scaled C50(O) Hierarchical, Fixed Hierarchical model. All calculations performed NONMEM VI (Icon Development Solutions, Ellicott City, MD). Results The strongly synergistic for both hypnotic analgesic components anesthesia. Greco model did not result plausible parameter estimates. slightly better than models, whereas Minto fitted less well. Conclusion showed importance exploring various approaches when studying interactions. fits our data best appears be an appropriate use hypnotic-opioid interaction.