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Comparison of two pharmacokinetic–pharmacodynamic models of rocuronium bromide during profound neuromuscular block: analysis of estimated and measured post-tetanic count effect

2022-03Journal article Restricted access
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dc.contributor.authorCouto, Mafalda
dc.contributor.authorVide, Sérgio
dc.contributor.authorMarco-Ariño, Nicolás
dc.contributor.authorTroconiz, Iñaki F.
dc.contributor.authorEsteves, Simão
dc.contributor.authorNunes, Catarina S.
dc.contributor.authorAmorim, Pedro
dc.contributor.authorMendes, Joaquim
dc.date.accessioned2022-06-28T14:06:28Z
dc.date.available2022-06-28T14:06:28Z
dc.date.issued2022-03
dc.description.abstractBackground: Profound neuromuscular block (NMB) is important in surgeries where complete immobility is considered essential to improve tracheal intubation and surgical conditions. Rocuronium bromide is a commonly used NMB agent. This work describes a noninvasive approach for estimation of post-tetanic count (PTC) based on two pharmacokinetic (PK) models, the Saldien and the De Haes models. The aim was to investigate the rocuronium bromide PKepharmacodynamic (PD) relationship in estimating the PTC effect during profound NMB. Methods: In this prospective, non-randomised, observational study, an induction bolus of rocuronium bromide was administered followed by continuous infusion for maintenance of a PTC of 1-2. measured every 3 min. Measurements were analysed as discrete categorical data and by applying the nonlinear mixed-effect modelling approach. Performance of the selected models was evaluated through simulation model-based diagnostics, further assessing the precision of the parameter estimates and the performance of the models at the individual level. Results: Data from 30 adult patients undergoing elective abdominal or neurosurgical procedures were included. Posttetanic count response profiles during rocuronium bromide infusion were successfully characterised using the population PD analysis. The models showed a good performance for all PTC categories, albeit with a moderate over-prediction of PTC >6. Conclusions: Our findings indicate that using plasma concentrations of rocuronium bromide estimated with either of the two models, combined with a PD model, provides equal model performance when predicting PTC. These promising results may provide an important advance in guiding rocuronium bromide administration when profound NMB in routine clinical practice is desired.pt_PT
dc.description.sponsorshipThe authors express great appreciation for the funding of project INEGI/LAETA UID/EMS/50022/2013 and PhD programme from FCTeMIT Portugal: LTI-EDAM (PD/BD/114378/2016).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMafalda Couto, Sérgio Vide, Nicolás Marco-Ariño, Iñaki F. Troconiz, Simão Esteves, Catarina S. Nunes, Pedro Amorim, Joaquim Mendes, Comparison of two pharmacokinetic–pharmacodynamic models of rocuronium bromide during profound neuromuscular block: analysis of estimated and measured post-tetanic count effect, British Journal of Anaesthesia, Volume 128, Issue 3, 2022, Pages 473-481, ISSN 0007-0912, https://doi.org/10.1016/j.bja.2021.12.010.pt_PT
dc.identifier.doi10.1016/j.bja.2021.12.010pt_PT
dc.identifier.issn1471-6771
dc.identifier.pmid35120713
dc.identifier.urihttp://hdl.handle.net/10400.2/11996
dc.identifier.wos000761787900029
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationAssociate Laboratory of Energy, Transports and Aeronautics
dc.relationLeaders for Tevhnical Industries - LTI - Deep neuromuscular blckade monitoring: closed-loop monitor system for deep neuromuscular blockade during surgery
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/abs/pii/S0007091221007996?via%3Dihubpt_PT
dc.subjectNeuromuscular blockpt_PT
dc.subjectPharmacokinetics-epharmacodynamicspt_PT
dc.subjectPost-tetanic countpt_PT
dc.subjectProfound blockadept_PT
dc.subjectRocuronium bromidept_PT
dc.titleComparison of two pharmacokinetic–pharmacodynamic models of rocuronium bromide during profound neuromuscular block: analysis of estimated and measured post-tetanic count effectpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleAssociate Laboratory of Energy, Transports and Aeronautics
oaire.awardTitleLeaders for Tevhnical Industries - LTI - Deep neuromuscular blckade monitoring: closed-loop monitor system for deep neuromuscular blockade during surgery
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FEMS%2F50022%2F2013/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/POR_NORTE/PD%2FBD%2F114378%2F2016/PT
oaire.citation.endPage481pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage473pt_PT
oaire.citation.titleBritish Journal of Anaesthesiapt_PT
oaire.citation.volume128pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStreamPOR_NORTE
person.familyNameCouto
person.familyNameVide
person.familyNameEsteves
person.familyNameDa Costa Nunes Duarte
person.familyNameAmorim
person.familyNameMendes
person.givenNameMafalda
person.givenNameSérgio
person.givenNameSimão
person.givenNameCatarina Sofia
person.givenNamePedro
person.givenNameJoaquim
person.identifierR-000-7HY
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person.identifier.orcid0000-0003-0305-1842
person.identifier.orcid0000-0002-8357-0994
person.identifier.orcid0000-0001-7466-4174
person.identifier.orcid0000-0003-4254-1879
person.identifier.ridO-5655-2016
person.identifier.scopus-author-id55429654100
person.identifier.scopus-author-id35931916900
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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