The Management of Intravenous Patient-controlled Analgesia with Simulations Based on the Pharmacokinetics and Pharmacodynamics of Fentanyl

Abstract

  The effect site concentration of fentanyl during postoperative day 1 was simulated with a linear 3-compartment model, and an IV-PCA (intravenous patient-controlled analgesia) menu was created on the basis of the simulation result. The relation between postoperative effect site concentration and analgesic effect was then reviewed. The simulation indicates that the intravenous administration of 300 μg fentanyl accompanied with basal administration of 25 μg/h fentanyl, at 2h before the emergence, maintains a stable effect site concentration of 1.0 ng/ml in a 50-kg patient. The effect site concentrations of fentanyl, 1.4 ng/ml in the emergent period and 1.0 ng/ml in postoperative period, are useful in postoperative analgesia in non-abdominal surgery.