• Laura N Hannivoort, Anthony R Absalom, and Struys Michel M R F MMRF Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .
• Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
• Curr Opin Anaesthesiol. 2020 Aug 1; 33 (4): 483-489.

Purpose Of ReviewGrowing concerns about the environmental effects of volatile anaesthetics are likely to lead to increased use of intravenous anaesthetic drugs. Pharmacokinetic/pharmacodynamic (PKPD) models can increase the accuracy of intravenous drug titration, especially in populations that differ from the 'average.' However, with a growing number of PKPD models, and other technology available to date, it can be hard to see the wood for the trees. This review attempts to guide the reader through the PKPD jungle.Recent FindingsGeneral purpose PKPD models for propofol and remifentanil designed to apply to a broader population, including children, the elderly and the obese, reduce the need for population-specific models. PKPD models for drugs such as dexmedetomidine and antimicrobial agents may be useful for procedural sedation or in the ICU. Technological advances such as Bayesian model adjustment based on point-of-care plasma concentration measurements, closed-loop drug delivery and artificial intelligence may improve the ease of use of the anaesthetic drugs and increase the accuracy of titration.SummaryNewer and more complex modelling techniques and technological advancements can help to deliver anaesthetic drugs, sedatives and other drugs in a more stable and thereby safer way.

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