Pediatric anesthesia & critical care
Assessment of the antinociceptive effect of a single fentanyl bolus dose in children: A pharmacokinetic and pharmacodynamic analysis based on the nociception level index during sevoflurane general anesthesia
Authors' conclusion
The Nociception Level Index showed superior capability compared to traditional hemodynamic variables in discriminating different nociception-antinociception levels during varying fentanyl concentrations in children under sevoflurane anesthesia.
Study context
- Population
- Children, 5.3 (4.1–6.7) years, scheduled for lower abdominal or urological surgery under sevoflurane GA and caudal block
- Participants
- 19 children
- Exposure
- Nociception Level Index, HR, MAP and bispectral index responses to standardized tetanic stimuli before and after fentanyl 2 μg/kg IV bolus
- Outcome
- Nociception Level Index ability to identify a standardized nociceptive stimulus and the analgesic effect of a fentanyl bolus
Methodological detailssingle-group, sequential PK/PD modelling (NONMEM®)
- Single-group
- Sequential PK/PD modelling (NONMEM®)
Main finding
As reported in the abstract
Nociception Level Index increased after first tetanic stimulus vs baseline (8 ± 7 vs. 19 ± 10)
−12
−18--6
HR increased after first tetanic stimulus vs baseline (100 ± 10 vs. 102 ± 10)
−2
−4--0.1
Nociception Level Index decreased after fentanyl (19 ± 10 vs. 8 ± 8)
12
5–18
HR decreased after fentanyl (102 ± 10 vs. 91 ± 11)
11
7–16
Observational data: associations, not effects.
Further findings
Fentanyl PK/PD model
- Plasma effect-site equilibration half-time (hysteresis), min
- 1.69 (0.4-2.9)
- Fentanyl C50, ng/mL
- 1.93 (0.73-4.2)
- PK best characterized by allometric weight-scaled, 3-compartment model
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →