Intravenous drug dose optimization and drug effect monitoring in anaesthesia
This thesis describes the importance of anesthetic drug dose optimization and the means that anesthetists have to achieve this.
Two main subjects were addressed. First, the influence of frontal brain tumour on the pharmacokinetics (the study of how an organism affects a drug) and pharmacodynamics (the study of what a drug does to the body) of propofol was explored in patients undergoing a craniotomy. In our studies we found that the frontal brain tumours influence the pharmacokinetics but not the pharmacodynamics of propofol.
Second, the efficacy of new hypnotic and analgesic EEG derived drug effect measures to improve drug dosing was investigated. We conclude that the new generation of monitors represent progress compared to the current state of affairs of drug dosing based on fixed dosing schemes and hemodynamic variables. However, they all still have important shortcomings which need to be addressed in future studies.