Dexmedetomidine pharmacodynamics in healthy volunteers: 2. Haemodynamic profile

P. J. Colin*, L. N. Hannivoort, D. J. Eleveld, K. M. E. M. Reyntjens, A. R. Absalom, H. E. M. Vereecke, M. M. R. F. Struys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background. Dexmedetomidine, a selective alpha(2)-adrenoreceptor agonist, has unique characteristics, with little respiratory depression and rousability during sedations. We characterized the haemodynamic properties of dexmedetomidine by developing a pharmacokinetic-pharmacodynamic (PKPD) model with a focus on changes in mean arterial blood pressure (MAP) and heart rate.

Methods. Dexmedetomidine was delivered i.v. to 18 healthy volunteers in a step-up fashion by target-controlled infusion using the Dyck model. Exploratory PKPD modelling and covariate analysis were conducted in NONMEM.

Results. Our model adequately describes dexmedetomidine-induced hypotension, hypertension, and bradycardia, with a greater effective concentration for the hypertensive effect. Changes in MAP were best described by a double-sigmoidal Emax model with hysteresis. Covariate analysis revealed no significant covariates apart from age on the baseline MAP in the population pharmacokinetic model used to develop this PKPD model. Simulations revealed good general agreement with published descriptive studies of haemodynamics after dexmedetomedine infusion.

Conclusions. The present integrated PKPD model should allow tighter control over the desired level of sedation, while limiting potential haemodynamic side-effects.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalBritish Journal of Anaesthesia
Volume119
Issue number2
DOIs
Publication statusPublished - 1-Aug-2017

Keywords

  • dexmedetomidine
  • haemodynamics
  • healthy volunteers
  • hypnotics and sedatives
  • pharmacology
  • ADULT HUMAN VOLUNTEERS
  • INTRAVENOUS DEXMEDETOMIDINE
  • PLASMA-CONCENTRATIONS
  • CONTROLLED INFUSION
  • HUMANS
  • HYDROCHLORIDE
  • MODEL

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