Pharmacokinetic study for target controlled infusion of ketamine and fentanyl

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With the help of pharmacokinetic principles it is possible to develop infusion schemes that rapidly obtain an predefined blood concentration of the infused drug and thereafter maintain this concentration. An example of such a scheme is the two-stage (2mg/kg, 2mg/kg/h)infusion regimen for ketamine intended to maintain the blood concentration at 1.0mug/ml. However, the requirement for anesthetic drugs varies from patient to patient and also for an individual patient according to the nature and intensity of the surgical stimulus. The differential equations involved in calculating the infusion rates needed to achieve and maintain a given target blood concentration are too complicated to perform by hand in the operating theater. For a computer these calculations are easy to perform and infusion schemes can be calculated for any target blood concentration in real time. By connecting a computer to a remotely controllable infusion pump a system is obtained with which intravenous drugs can be delivered with greater ease than inhalation anesthetics with a vaporizer. These systems are called computer controlled infusion devices or Target Controlled Infusion Devices (TCI) . Hirosaki was the first centers involved in the evaluation of these new systems in Japan. Another study results which we performed was a scheme of fentanyl infusion dose including 5-15mug/kg to get 3-5ng/ml blood concentration.