title: Impact of peripheral elimination on the concentration-effect relationship of remifentanil in anaesthetized dogs.
abstract: BACKGROUND
  This study elucidates the impact of sampling site when estimating pharmacokinetic-pharmacodynamic (PK-PD) parameters of drugs such as remifentanil that undergo tissue extraction in the biophase. The interrelationship between the concentrations of remifentanil predicted for the effect compartment and those measured in arterial, venous, and cerebrospinal fluid were investigated under steady-state conditions.
  
  
  METHODS
  Following induction of anaesthesia with pentobarbital, an arterial cannula (femoral) and two venous catheters (jugular and femoral) were inserted. Electrodes were placed for EEG recording of theta wave activity. Each dog received two consecutive 5-min infusions for the PK-PD study and a bolus followed by a 60-min infusion was started for the steady-state study. Cerebrospinal fluid, arterial and venous blood samples were drawn simultaneously after 30, 40, and 50 min. At the end of the infusion, arterial blood samples were collected for pharmacokinetic analysis.
  
  
  RESULTS
  Remifentanil PK-PD parameters based on theta wave activity were as follows: apparent volume of distribution at steady-state (V(ss)) (231+/-37 ml kg(-1)), total body clearance (Cl) (63+/-16 ml min(-1) kg(-1)), terminal elimination half-life (t(1/2 beta)) (7.71 min), effect compartment concentration at 50% of maximal observed effect (EC(50)) (21+/-13 ng ml(-1)), and equilibration rate constant between plasma and effect compartment (k(e0)) (0.48+/-0.24 min). The mean steady-state cerebrospinal fluid concentration of 236 ng ml(-1) represented 52 and 74% of that in arterial and venous blood, respectively.
  
  
  CONCLUSIONS
  Our study re-emphasizes the importance of a sampling site when performing PK-PD modelling for drugs undergoing elimination from the effect compartment. For a drug undergoing tissue elimination such as remifentanil, venous rather than arterial concentrations will reflect more exactly the effect compartment concentrations, under steady-state conditions.
authors.affiliation: Faculté de Pharmaci, Université de Montréal, Montréal, Québec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Kabbaj
authors.forename: P
authors.initials: P
authors.lastname: Vachon
authors.forename: F
authors.initials: F
authors.lastname: Varin
mesh_terms: D000701:Analgesics, Opioid / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight; D004285:Dogs; D005263:Femoral Artery; D005268:Femoral Vein; D006207:Half-Life; D006339:Heart Rate / Q000187:drug effects; D006400:Hematocrit; D007601:Jugular Veins; D008954:Models, Biological; D010424:Pentobarbital; D010880:Piperidines / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D000077208:Remifentanil; D013048:Specimen Handling / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D010424:Pentobarbital; D000077208:Remifentanil