Rosa DJ, Navarrete ZV

Language: Spanish
References: 7
Page: 220-230
PDF size: 256.74 Kb.

ABSTRACT

Introduction: automated drug dispensing systems are research tools with a high impact on the practice of anesthesiology.
Objective: present a methodology that enables the adjustment of estimations for the design of a manual dispensing regimen for midazolam based on a multicompartmental model.
Method: an analytical pharmacokinetic simulation study was conducted using the parameters in the Greenblatt model. Error percentage, median performance error (MDPE) and estimation mean error (EME) were calculated for the analysis of results.
Results: the Vd tpeak value estimated was 1302 ml / kg. The loading dose determined was 0.26 mg / kg. For the corrected mean value of CLc equals 32 ml / kg / min, the estimated Vinfi was adjusted according to the formula Vinfi = CpD x CL, whereas temporal variation was adjusted according to regimens Vinf (tn) = Vinf (tn- 1) - [(Vinf (tn-1) x e(1 + 1/t)t)/100] and Vinf(tn) = Vinf (tn-1) x 0.85.
Conclusions: a methodology was designed for manual TIVA administration of midazolam which yielded a minimum error with respect to the automated regime (TCI).

REFERENCES

1. Henthorn T K. The Effect of Altered Physiological States on Intravenous Anesthetics. En: Schüttler J, Schwilden H. Modern Anesthetics. Springer-Verlag. Berlin. Heidelberg; 2008.pp.363·78.

2. Vanegas SA. Anestesia Intravenosa. Bogotá: Editorial Médica internacional; 2008.p.75-78.

3. Díaz JR, Zuazo VN, Sánchez EF. Variante de cálculo de infusión de midazolam en la TIVA manual. Rev Cub Anest y Reanim 2013; 12(3): En línea. [Consultado: enero 12, 2014]. URL disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726- 67182013000300004&lng=es&nrm=iso.

4. Glass PS, Shafer SL, Reves JG. Sistemas de administración de fármacos intravenosos. En: Miller RD. Anestesia. 6ta edición. Madrid. España: Elsevier; 2005. pp. 439 - 80.

5. Predictibilidad Farmacológica y TIVA. En: Voullième PS. La Anestesia Intravenosa II. Actualizaciones en modelación, drogas y tecnologías complementarias.1ra Ed. Chile: Salecianos SA; 2006.p.59·91.

6. Voullième PS. ¿Cómo construir una TIVA manual? En: Voullième PS. Anestesiología Clínica. Chile: Ed. Damuji; 2001.p.61-72.

7. Reves J. Benzodiazepines. In: Prys-Roberts. Pharmacokinetics of Anestesia. Boston: Blackwell; 1984.p.157.