Pharmacodynamic mechanism-based interaction model for the haemodynamic effects of remifentanil and propofol in healthy volunteers
Authors' conclusion
The structure of the previous mechanism-based haemodynamic model for propofol was able to describe the effects of remifentanil alone on haemodynamic variables. The GPDI model provided a good framework for characterising the pharmacodynamic interaction between remifentanil and propofol on haemodynamic properties.
Study context
- Population
- Healthy volunteers2 clinical trials
- Comparison
- Remifentanil alone vs propofol alone vs combination
- Outcome
- Haemodynamic interactions between remifentanil and propofol (mechanism-based model, general pharmacodynamic interaction (GPDI))
Methodological detailspharmacodynamic modelling, pooled data from two clinical trials
- Pharmacodynamic modelling
- Pooled data from two clinical trials
Main finding
As reported in the abstract
- Remifentanil alone: increase in dissipation rate of total peripheral resistance at 3.0 ng ml-1
- 50%
- Remifentanil: attenuation of HR dissipation rate per 1 ng ml-1 increase
- 4.8%
- Remifentanil: attenuation of stroke volume dissipation rate per 1 ng ml-1 increase
- 4.9%
- Propofol alone: maximal decrease in production rate of total peripheral resistance
- 78%
- Propofol maximal effect on total peripheral resistance combined with remifentanil 4 ng ml-1
- 32%
- Maximum decrease of remifentanil effect on HR by propofol
- 11.9%
- Maximum decrease of remifentanil effect on stroke volume by propofol
- 21.2%
Further findings
Model performance
- Goodness-of-fit and prediction-corrected visual predictive check plots showed good predictive performance
Original publication
Pharmacodynamic mechanism-based interaction model for the haemodynamic effects of remifentanil and propofol in healthy volunteers. Br J Anaesth. Published 22 June 2023. doi:10.
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