title: Performance evaluation of paediatric propofol pharmacokinetic models in healthy young children.
abstract: BACKGROUND
  The performance of eight currently available paediatric propofol pharmacokinetic models in target-controlled infusions (TCIs) was assessed, in healthy children from 3 to 26 months of age.
  
  
  METHODS
  Forty-one, ASA I-II children, aged 3-26 months were studied. After the induction of general anaesthesia with sevoflurane and remifentanil, a propofol bolus dose of 2.5 mg kg(-1) followed by an infusion of 8 mg kg(-1) h(-1) was given. Arterial blood samples were collected at 1, 2, 3, 5, 10, 20, 40, and 60 min post-bolus, at the end of surgery, and at 1, 3, 5, 30, 60, and 120 min after stopping the infusion. Model performance was visually inspected with measured/predicted plots. Median performance error (MDPE) and the median absolute performance error (MDAPE) were calculated to measure bias and accuracy of each model.
  
  
  RESULTS
  Performance of the eight models tested differed markedly during the different stages of propofol administration. Most models underestimated propofol concentration 1 min after the bolus dose, suggesting an overestimation of the initial volume of distribution. Six of the eight models tested were within the accepted limits of performance (MDPE<20% and MDAPE<30%). The model derived by Short and colleagues performed best.
  
  
  CONCLUSIONS
  Our results suggest that six of the eight models tested perform well in young children. Since most models overestimate the initial volume of distribution, the use for TCI might result in the administration of larger bolus doses than necessary.
authors: Departamento de Anestesiología, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
authors: P
authors: P
authors: Sepúlveda
authors: L I
authors: LI
authors: Cortínez
authors: C
authors: C
authors: Sáez
authors: A
authors: A
authors: Penna
authors: S
authors: S
authors: Solari
authors: I
authors: I
authors: Guerra
authors: A R
authors: AR
authors: Absalom
mesh_terms: D000465:Algorithms; D018686:Anesthetics, Intravenous / Q000097:blood / Q000493:pharmacokinetics*; D002138:Calibration; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015233:Models, Statistical; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000097:blood / Q000493:pharmacokinetics*; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol