Physiological Modeling of Concentration-Effect Relationship for Nondepolarizing Neuromuscular Blocking Drugs
Physiological Modeling of Concentration-Effect Relationship for Nondepolarizing Neuromuscular Blocking Drugs
复制标题
DOI：
10.1109/embc44109.2020.9175229
复制
发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Hikaru Hoshino;E. Furutani;Tomonori Sugawara;T. Takeda;Yoshiharu Sawanobori;G. Shirakami
中科院分区：
文献类型：
--
作者：
Hikaru Hoshino;E. Furutani;Tomonori Sugawara;T. Takeda;Yoshiharu Sawanobori;G. Shirakami
本文报道了在全身麻醉中使用非去极化神经肌肉阻滞剂（NDNB）时神经肌肉传递生理过程的模型。NDNB被认为是通过与位于连接前和连接后位点的乙酰胆碱受体相互作用而起作用。本文提出了一个扩展的标准模型，用于在神经科学领域的突触抑制来描述的连接前效应的NDNBs。扩展模型，然后结合先前提出的模型的连接后的效果来模拟神经肌肉传递的整个过程。该模型可用于预测NDNBs的药物浓度与其实际作用之间的药理学关系。具体而言，该模型首先能够估计强直后计数（PTC），这是深度神经肌肉阻滞（NMB）的临床使用的监测措施。通过比较模拟结果与从接受外科手术的患者获得的临床数据，所得到的模型的有效性进行了讨论。
This paper reports modeling of physiological processes of neuromuscular transmission considering effects of nondepolarizing neuromuscualr blocking drugs (NDNBs) used during general anesthesia. NDNBs are considered to act by interacting with acetylcohine receptors located at pre- and post-junctional sites. This paper proposes an extension of the standard model of synaptic depression used in the field of neuroscience to describe the pre-junctional effect of NDNBs. The extended model is then combined with a previously proposed model of the post-junctional effect to simulate the whole process of neuromuscular transmission. The derived model can be used to predict pharmacologic relationship between the drug concentration and its actual effect of NDNBs. Specifically, the model firstly enables the estimation of Post-tetanic Count (PTC), a clinically used monitoring measure for deep neuromuscular blockade (NMB). The effectiveness of the derived model is discussed by comparing simulation results with clinical data obtained from a patient undergoing a surgical operation.