Performance of classical and physiologically-based PK-PD modelling for prediction of remifentanil hemodynamic effects

Nowadays, the induction and maintenance of a balanced anesthesia require new methods and tools. In this respect, pharmacokinetic-pharmacodynamic (PK-PD) models can be useful, as they provide the relationship between the drug dose and its pharmacological effect. Remifentanil is an extensively employed analgesic opioid in anesthesia, and its pharmacokinetics and pharmacodynamics are usually described and predicted by a classical three-compartment PK model, combined with the Hill equation. Aim of this study is to develop a physiologically-based (PB) PK/PD model for the administration of remifentanil, compare the results with the classical methodology, and discuss the possibility of application of this model to an automated control-loop for anesthesia induction and maintenance.