A prospective study for validation of Bayesian prediction approach to adjust individual lidocaine dosage. 1994

T Uematsu, and H Hirayama, and K Umemura, and K Kosuge, and M Nakashima
Department of Pharmacology, Hamamatsu University School of Medicine, Shizuoka, Japan.

A Bayesian approach, in which the estimates of the population pharmacokinetic parameters of lidocaine reported by Vozeh et al. [1984 a and b] and one measurement of serum lidocaine concentration as feedback information were utilized, was prospectively evaluated in 20 Japanese patients. The concentration of lidocaine in serum sampled from each patient at 1.5 to 3 hours after the commencement of i.v. lidocaine therapy was measured and the most likely pharmacokinetic parameters of that patient were predicted by the Bayesian program for microcomputer. Having the predicted parameters, we got the concentrations of lidocaine at 12 and 24 hours (C12 and C24) after starting the therapy within the recommended therapeutic range (2-5 micrograms/ml) by adjusting the individual dosage. As a result, the values of C12 and C24 remained within the therapeutic range in all patients and in all except one, respectively. The mean % prediction error (measured minus predicted concentration standardized by measured one) and its 95% confidence interval were 1.8% and -11.4 to 14.7% for C12, and -2.3% and -11.9 to 7.4% for C24, showing that the prediction of both C12 and C24 was not biased. The correlation coefficients between the measured and predicted concentrations were 0.574 for C12 and 0.721 for C24 (p < 0.01). From these findings, the present Bayesian method implemented with the estimates of pharmacokinetic parameters in a Swiss patient population is useful for sufficiently accurate and precise assessment of individual dosage requirement within a few hours after starting lidocaine therapy.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008297 Male Males
D008838 Microcomputers Small computers using LSI (large-scale integration) microprocessor chips as the CPU (central processing unit) and semiconductor memories for compact, inexpensive storage of program instructions and data. They are smaller and less expensive than minicomputers and are usually built into a dedicated system where they are optimized for a particular application. "Microprocessor" may refer to just the CPU or the entire microcomputer. Computers, Personal,Microprocessors,Computer, Personal,Microcomputer,Microprocessor,Personal Computer,Personal Computers
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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