Population pharmacokinetics and pharmacodynamics in anesthesia, intensive care and pain medicine

PURPOSE OF REVIEW: Population modeling is a relatively new pharmacological discipline, the development of which has largely been stimulated by the need for accurate models for the pharmacokinetics and dynamics of anesthetic agents. RECENT FINDINGS: Population-based modeling is now considered superior to older, more traditional modeling methods. Nonlinear mixed-effect modeling - a commonly used population-based modeling approach - estimates intraindividual and interindividual variability, limits the influence of outlying samples and individuals through the use of Bayesian statistical analysis, and provides a potential means of optimizing drug delivery regimens, especially when used to define pharmacokinetic-dynamic models for target-controlled infusion systems. In addition to being used for pharmacokinetic modeling, in which the influence of factors such as age, weight and illness can be studied, it is a powerful tool for the study of the influence of multiple factors on drug pharmacodynamics. SUMMARY: Nonlinear mixed-effect population-based modeling has become the gold standard method of pharmacokinetic and pharmacodynamic analysis during new drug development and during subsequent pharmacological studies. Population-based modeling techniques have been applied to numerous aspects of drug delivery in anesthesia, intensive care and pain medicine.