[Clinical applications of intravenous anaesthetics pharmacology: the example of hypnotics and opioids].

OBJECTIVE

To review the general principles of pharmacokinetics and pharmacodynamics models by focusing on intravenous anaesthetics (hypnotics and opioids).

DATA SOURCES: Medline references, lectures from the French congress of anaesthesiology and intensive care medicine, abstracts.

DATA SYNTHESIS: Pharmacokinetic and pharmacodynamic modelling allows simple estimation of becoming of anaesthetic drugs in the body, instead of classical pharmacologic approach. However, pharmacokinetic as well as pharmacodynamic parameters are often considered as resulting from complex mathematic approaches and remain then poorly used in practice by physicians. The aim of this article is to simply expose concepts underlying PK-PD models building and to explain significance of the main PK-PD parameters (first-order rate constants, k(e0), T(1/2)k(e0), T(peak), context-sensitive half-time, context-sensitive decrement times). Clinical consequences for using intravenous anaesthetic drugs (hypnotics and opioids) are exposed either during bolus injection or continuous infusion, when injected alone or co-administered.