Naunyn-Schmiedeberg's archives of pharmacology
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Naunyn Schmiedebergs Arch. Pharmacol. · Oct 2013
Randomized Controlled TrialNon-invasive combined surrogates of remifentanil blood concentrations with relevance to analgesia.
Surrogates may provide easy and quick access to information about pharmacological parameters of interest that can be directly measured only with difficulty. Surrogates have been proposed for opioid blood concentrations to replace invasive sampling, serving as a basis for target-controlled infusion systems to optimize analgesia. We aimed at identifying surrogates of remifentanil steady-state blood concentrations with relevance for its clinical, in particular, analgesic, effects. ⋯ This combination of pharmacodynamic parameters provided even better predictions of analgesia than could be obtained using the measured opioid blood concentrations. Developing surrogates only for opioid blood concentrations is insufficient when opioid effects are the final goal. Combining pharmacodynamic surrogate parameters seems to provide a promising approach to obtain acceptable predictions of relevant clinical effects, with better results than obtained with measuring or estimating blood concentrations.
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Naunyn Schmiedebergs Arch. Pharmacol. · Feb 2010
Randomized Controlled TrialAbsorption and distribution of etoricoxib in plasma, CSF, and wound tissue in patients following hip surgery--a pilot study.
The perioperative administration of selective cyclooxygenase-2 (COX-2)-inhibitors to avoid postoperative pain is an attractive option: they show favorable gastro-intestinal tolerability, lack inhibition of blood coagulation, and carry a low risk of asthmatic attacks. The purpose of this study was to determine the cerebrospinal fluid (CSF), plasma, and tissue pharmacokinetics of orally administered etoricoxib and to compare it with effect data, i.e., COX-2-inhibition in patients after hip surgery. The study was performed in a blinded, randomized, parallel group design. ⋯ Individual CSF lag times with respect to (50%) peak plasma concentration were