Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2007 May;98(5):615-23.
doi: 10.1093/bja/aem063. Epub 2007 Mar 27.

Predictive performance of the Domino, Hijazi, and Clements models during low-dose target-controlled ketamine infusions in healthy volunteers

A R Absalom  1 , M Lee, D K Menon, S R Sharar, T De Smet, J Halliday, M Ogden, P Corlett, G D Honey, P C Fletcher
Affiliations
Comparative Study

Predictive performance of the Domino, Hijazi, and Clements models during low-dose target-controlled ketamine infusions in healthy volunteers

A R Absalom et al. Br J Anaesth. 2007 May.

Abstract

Background: Healthy volunteers received low-dose target-controlled infusions (TCI) of ketamine controlled by the Domino model while cognitive function tests and functional neuroimaging were performed. The aim of the current study was to assess the predictive performance of the Domino model during these studies, and compare it with that of three other ketamine models.

Methods: Fifty-eight volunteers received ketamine administered by a TCI device on one or more occasions at target concentrations of either 50, 100, or 200 ng ml-1. At each target concentration, two or three venous blood samples were withdrawn during infusion, with a further sample after the infusion ended. Ketamine assays were performed by gas chromatography. The plasma concentration time courses predicted by the Hijazi, Clements 125, and Clements 250 models were calculated retrospectively, and the predictive performance of each of the models was assessed using Varvel methodology.

Results: For the Domino model, bias, inaccuracy, wobble, and divergence were - 2.7%, 33.9%, 24.2%, and 0.1463% h-1, respectively. There was a systematic increase in performance error over time. The Clements 250 model performed best by all criteria, whereas the Hijazi model performed least well by all criteria except for bias.

Conclusions: Performance of the Domino model during control of low-dose ketamine infusions was sub-optimal. The Clements 250 model may be a better model for controlling low-dose TCI ketamine administration.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Measured ketamine concentrations (ng ml−1). Each filled circle represents one data point. Lines linking data points indicate which samples came from the same subject, and do not indicate estimated or extrapolated concentrations between samples.
Fig 2
Fig 2
Measured and predicted ketamine concentrations over time. Vertical bars represent the mean (SD) measured ketamine concentrations, but depicted at the average time (from the start of the infusions) at which the samples were obtained. Horizontal bars in the middle of the vertical bars represent the SD of the time interval at which the samples were obtained.
Fig 3
Fig 3
Trends in mean performance errors for each of the models during the different studies.
See this image and copyright information in PMC

References

    1. Himmelseher S, Durieux ME. Revising a dogma: ketamine for patients with neurological injury? Anesth Analg. 2005;101:524–34. - PubMed
    1. Koppert W, Sittl R, Scheuber K, Alsheimer M, Schmelz M, Schuttler J. Differential modulation of remifentanil-inducedanalgesia and postinfusion hyperalgesia by S-ketamine and clonidine in humans. Anesthesiology. 2003;99:152–9. - PubMed
    1. Bell RF, Dahl JB, Moore RA, Kalso E. Perioperative ketamine for acute postoperative pain. Cochrane Database Syst Rev. 2006:CD004603. - PubMed
    1. Bourgoin A, Albanese J, Leone M, Sampol-Manos E, Viviand X, Martin C. Effects of sufentanil or ketamine administered in targetcontrolled infusion on the cerebral hemodynamics of severely brain-injured patients. Crit Care Med. 2005;33:1109–13. - PubMed
    1. Hijazi Y, Bodonian C, Bolon M, Salord F, Boulieu R. Pharmacokinetics and haemodynamics of ketamine in intensive care patients with brain or spinal cord injury. Br J Anaesth. 2003;90:155–60. - PubMed

Publication types