ArticleJournal of anesthesia, analgesia and critical care2026
Target concentrations of propofol predicted by four different pharmacokinetic/pharmacodynamic models to induce loss of consciousness in neurosurgical patients.
Article in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTarget-controlled infusion (TCI) systems estimate plasma (Cp) and effect-site (Ce) drug concentrations using pharmacokinetic-pharmacodynamic (PK/PD) models rather than direct measurements. Because multiple models are used in clinical practice, predicted concentrations at the same clinical endpoint may differ substantially. Loss of consciousness (LOC) during anesthesia induction provides a clinically relevant reference point for examining these differences.
methodsWe conducted a retrospective analysis of patients undergoing elective brain or spine surgery under propofol-based anesthesia. The propofol dose required to induce LOC was recorded, and plasma (Cp) and effect-site (Ce) concentrations at LOC were retrospectively estimated using four widely used PK/PD models (Marsh, Modified Marsh, Schnider, and Eleveld) through TCI simulation. Differences in model-derived concentrations were analyzed using mixed two-way ANOVA, with Model as a within-subject factor and Surgical Group (brain vs spine surgery) as a between-subject factor. When significant interactions were observed, post hoc comparisons were performed on log-transformed Ce values.
resultsModel-derived concentrations at LOC differed markedly across PK/PD models. Mean Ce values ranged from approximately 1.5 µg/mL with the Marsh and Eleveld models to 4.6 µg/mL with the Schnider model. Mixed ANOVA showed a strong model effect on both Ce and Cp (p < 0.001). A significant Model × Surgical Group interaction was observed for Ce but not for Cp. Patients undergoing brain surgery received lower propofol doses and reached LOC at lower model-predicted effect-site concentrations than patients undergoing spine surgery.
conclusionsPredicted propofol concentrations at LOC vary considerably across PK/PD models despite identical clinical dosing, highlighting the model-dependent nature of TCI targets. These findings underscore the importance of explicit model specification and adequate user understanding when interpreting TCI-derived concentrations in both clinical practice and research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.