Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery
Abstract Sufentanil is frequently used as an anesthetic agent in cardiac surgery owing to its cardiovascular safety and favorable pharmacokinetics. However, the pharmacokinetics profiles of sufentanil in patients undergoing cardiopulmonary bypass (CPB) surgery remain less understood, which is crucia...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | CPT: Pharmacometrics & Systems Pharmacology |
| Online Access: | https://doi.org/10.1002/psp4.13205 |
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| author | Vipada Khaowroongrueng Kuk Hui Son Sang‐Min Lee JiYeon Lee Chun‐Gon Park Seok In Lee Dongseong Shin Kwang‐Hee Shin |
| author_facet | Vipada Khaowroongrueng Kuk Hui Son Sang‐Min Lee JiYeon Lee Chun‐Gon Park Seok In Lee Dongseong Shin Kwang‐Hee Shin |
| author_sort | Vipada Khaowroongrueng |
| collection | DOAJ |
| description | Abstract Sufentanil is frequently used as an anesthetic agent in cardiac surgery owing to its cardiovascular safety and favorable pharmacokinetics. However, the pharmacokinetics profiles of sufentanil in patients undergoing cardiopulmonary bypass (CPB) surgery remain less understood, which is crucial for achieving the desired level of anesthesia and mitigating surgical complications. Therefore, this study aimed to develop a population pharmacokinetic model of sufentanil in patients undergoing CPB surgery and elucidate the clinical factors affecting its pharmacokinetic profile. Adult patients who underwent cardiac surgery with CPB and were administered sufentanil for anesthesia were enrolled. Arterial blood samples were collected to quantify plasma concentrations of sufentanil and clinical laboratory parameters, including inflammatory cytokines. A population pharmacokinetic model was established using nonlinear mixed‐effects modeling. Simulations were performed using the pharmacokinetic parameters of the final model. Overall, 20 patients were included in the final analysis. Sufentanil pharmacokinetics were modeled using a two‐compartment model, accounting for CPB effects. Sufentanil clearance increased 2.80‐fold during CPB and warming phases, while the central compartment volume increased 2.74‐fold during CPB. CPB was a significant covariate affecting drug clearance and distribution volume. No other significant covariates were identified despite increased levels of the inflammatory cytokines, including IL‐6, IL‐8, and TNF‐α during CPB. The simulation indicated a 30 μg loading dose and 40 μg/h maintenance infusion for target‐controlled infusion. Additionally, a bolus dose of 60 μg was added at CPB initiation to adjust for exposure changes during this phase. Considering the target sufentanil concentrations, a uniform dosing regimen was acceptable for effective analgesia. |
| format | Article |
| id | doaj-art-dcbf466ea0a74a669ff319a08c7f1d07 |
| institution | OA Journals |
| issn | 2163-8306 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | CPT: Pharmacometrics & Systems Pharmacology |
| spelling | doaj-art-dcbf466ea0a74a669ff319a08c7f1d072025-08-20T02:09:14ZengWileyCPT: Pharmacometrics & Systems Pharmacology2163-83062024-10-0113101682169210.1002/psp4.13205Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgeryVipada Khaowroongrueng0Kuk Hui Son1Sang‐Min Lee2JiYeon Lee3Chun‐Gon Park4Seok In Lee5Dongseong Shin6Kwang‐Hee Shin7Research and Development Institute The Government Pharmaceutical Organization Bangkok ThailandDepartment of Thoracic and Cardiovascular Surgery, Gil Medical Center, College of Medicine Gachon University Incheon KoreaCollege of Pharmacy, Research Institute of Pharmaceutical Sciences Kyungpook National University Daegu KoreaDepartment of Anesthesiology and Pain Medicine, Gil Medical Center, College of Medicine Gachon University Incheon KoreaDepartment of Anesthesiology and Pain Medicine, Gil Medical Center, College of Medicine Gachon University Incheon KoreaDepartment of Thoracic and Cardiovascular Surgery, Gil Medical Center, College of Medicine Gachon University Incheon KoreaDepartment of Clinical Pharmacology and Therapeutics, Gil Medical Center, College of Medicine Gachon University Incheon KoreaCollege of Pharmacy, Research Institute of Pharmaceutical Sciences Kyungpook National University Daegu KoreaAbstract Sufentanil is frequently used as an anesthetic agent in cardiac surgery owing to its cardiovascular safety and favorable pharmacokinetics. However, the pharmacokinetics profiles of sufentanil in patients undergoing cardiopulmonary bypass (CPB) surgery remain less understood, which is crucial for achieving the desired level of anesthesia and mitigating surgical complications. Therefore, this study aimed to develop a population pharmacokinetic model of sufentanil in patients undergoing CPB surgery and elucidate the clinical factors affecting its pharmacokinetic profile. Adult patients who underwent cardiac surgery with CPB and were administered sufentanil for anesthesia were enrolled. Arterial blood samples were collected to quantify plasma concentrations of sufentanil and clinical laboratory parameters, including inflammatory cytokines. A population pharmacokinetic model was established using nonlinear mixed‐effects modeling. Simulations were performed using the pharmacokinetic parameters of the final model. Overall, 20 patients were included in the final analysis. Sufentanil pharmacokinetics were modeled using a two‐compartment model, accounting for CPB effects. Sufentanil clearance increased 2.80‐fold during CPB and warming phases, while the central compartment volume increased 2.74‐fold during CPB. CPB was a significant covariate affecting drug clearance and distribution volume. No other significant covariates were identified despite increased levels of the inflammatory cytokines, including IL‐6, IL‐8, and TNF‐α during CPB. The simulation indicated a 30 μg loading dose and 40 μg/h maintenance infusion for target‐controlled infusion. Additionally, a bolus dose of 60 μg was added at CPB initiation to adjust for exposure changes during this phase. Considering the target sufentanil concentrations, a uniform dosing regimen was acceptable for effective analgesia.https://doi.org/10.1002/psp4.13205 |
| spellingShingle | Vipada Khaowroongrueng Kuk Hui Son Sang‐Min Lee JiYeon Lee Chun‐Gon Park Seok In Lee Dongseong Shin Kwang‐Hee Shin Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery CPT: Pharmacometrics & Systems Pharmacology |
| title | Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery |
| title_full | Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery |
| title_fullStr | Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery |
| title_full_unstemmed | Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery |
| title_short | Population pharmacokinetic modeling of sufentanil in adult Korean patients undergoing cardiopulmonary bypass surgery |
| title_sort | population pharmacokinetic modeling of sufentanil in adult korean patients undergoing cardiopulmonary bypass surgery |
| url | https://doi.org/10.1002/psp4.13205 |
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