Simulation of propofol anaesthesia for intracranial decompression using brain hypothermia treatment.
BACKGROUND
Although propofol is commonly used for general anaesthesia of normothermic patients in clinical practice, little information is available in the literature regarding the use of propofol anaesthesia for intracranial decompression using brain hypothermia treatment. A novel propofol anaesthesia scheme is proposed that should promote such clinical application and improve understanding of the principles of using propofol anaesthesia for hypothermic intracranial decompression.


METHODS
Theoretical analysis was carried out using a previously-developed integrative model of the thermoregulatory, hemodynamic and pharmacokinetic subsystems. Propofol kinetics is described using a framework similar to that of this model and combined with the thermoregulation subsystem through the pharmacodynamic relationship between the blood propofol concentration and the thermoregulatory threshold. A propofol anaesthesia scheme for hypothermic intracranial decompression was simulated using the integrative model.


RESULTS
Compared to the empirical anaesthesia scheme, the proposed anaesthesia scheme can reduce the required propofol dosage by more than 18%.


CONCLUSIONS
The integrative model of the thermoregulatory, hemodynamic and pharmacokinetic subsystems is effective in analyzing the use of propofol anaesthesia for hypothermic intracranial decompression. This propofol infusion scheme appears to be more appropriate for clinical application than the empirical one.
Gaohua
Lu
L
Bio-Mimetic Control Research Center, The Institute of Physical and Chemical Research (RIKEN) Nagoya, 463-0003, Japan. lu@bmc.riken.jp
Kimura
Hidenori
H
D000758:Anesthesia; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D001158:Arteries; D001812:Blood-Brain Barrier; D001833:Body Temperature Regulation; D001921:Brain / Q000601:surgery*; D003198:Computer Simulation; D019299:Decompression, Surgical; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007036:Hypothermia, Induced; D008962:Models, Theoretical; D009994:Osmolar Concentration; D010539:Permeability; D015742:Propofol / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics
D018686:Anesthetics, Intravenous; D015742:Propofol