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

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...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 33; no. 6; pp. 953 - 958
Autores principales: Tams, Carl, Johnson, Ken, Seubert, Christoph
Formato: Journal Article
Publicado: Springer Nature Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2019
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      pub: Springer Nature
      place: New York, New York
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        atl: Acceptance of a propofol and remifentanil infusion dosing algorithm to optimize postoperative emergence and analgesia.
      aug:
        au:
          Tams, Carl
          Johnson, Ken
          Seubert, Christoph
        affil: Department of Anesthesiology, University of Utah, 30 N 1900 E, 84132, Salt Lake City, UT, USA
      sug:
        subj:
          Anesthesiology Standards
          Propofol Administration and Dosage
          Child
          Female
          Propofol Pharmacokinetics
          Scoliosis Surgery
          Postoperative Pain
          User-Computer Interface
          Pilot Studies
          Adolescence
          Anesthesia Recovery
          Analgesics, Opioid Administration and Dosage
          Decision Support Systems, Clinical
          Postoperative Period
          Computer Graphics
          Algorithms
          Pain Therapy
          Analgesics, Opioid Pharmacokinetics
          Anesthesiology Methods
          Young Adult
          Male
          Scales
          Child: 6-12 years
          Adolescent: 13-18 years
          Female
          Male
      ab: 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.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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