Validation of fentanyl pharmacokinetics in patients undergoing coronary artery bypass grafting

Abstract

Our pharmacokinetic model provides a rational foundation for designing fentanyl dose regimens for patients undergoing CABG. When combined with previously published information regarding intraoperative fentanyl pharmacodynamics, dose regimens that reliably achieve and maintain desired fentanyl concentrations throughout the intraoperative period can be designed to achieve specific therapeutic goals.

Cardiopulmonary Predicators of Dysfunctional Ventilator Weaning Response after Coronary Artery Bypass Graft

“…This finding implies that the patients who had lower CI developed DVWR. This finding is consistent with past literature that reported an alteration in cardiac index during weaning was found to have association with weaning failure (15,(76)(77)(78). However, the logistic prediction model revealed that CI is not a significant antecedence to predict the DVWR after CABG surgery.…”

Population Pharmacokinetics of Fentanyl in the Critically Ill*

“…Moreover, critical illness often results in failure of organs that affect pharmacokinetics, e.g., the liver, kidney, and heart. Yet, though population pharmacokinetic studies of fentanyl have been conducted in several populations, including healthy volunteers (7), burn patients (8), coronary artery bypass graft patients (9), and liver transplant patients (10), the pharmacokinetics of fentanyl for the heterogeneous medical/surgical ICU patient population has not been well studied.…”

Correlation of cardiac output and sevoflurane required to maintain anesthetic depth targeted with entropy index

“…Considering age of the patients and patterns of fentanyl administration, the above mentioned doses of fentanyl is likely to provide plasma concentrations ranging from 2.5 to 3.5 ng/ml. [12][13][14] Katoh et al studied the influence of fentanyl on sevoflurane pharmacodynamics and reported that afore mentioned fentanyl concentrations led to 50% reduction in the minimum alveolar concentration (MAC) of the volatile anesthetic, which corresponds to ETsev around 1.0%. ETsev reduction cannot be explained solely by the concomitant administration of fentanyl as its doses were similar in all patients, cases with CI ≤ 2.2 l/min/m 2 and cases with CI > 2.2 l/min/m 2 [ Table 1] which suggests a decrease in MAC in patients with low CO (CI ≤ 2.2 l/min/m 2 ).…”