2014
EMSS 2014 Proceeding
Probabilistic behavioral model for the detection of criticalities when using morphine and fentanyl PCA
Authors: Henrikas Pranevicius, Mindaugas Snipas, Tadas Kraujalis, Mindaugas Pranevicius, Osvaldas Pranevicius, Vytautas Pilkauskas
Abstract
When patient controlled analgesia (PCA) was originally introduced, the belief was that frequency of analgesic demand uniquely reflects the level of patient?s pain. However frequency of the demand is a random process that has its own distribution with a unique shape and parameters. We used this distribution to simulate the risk of drug concentration exceeding critical threshold. We used quantized state system model to create hybrid aggregate model of PCA. We investigated two randomly selected, real data based, unidentified morphine and fentanyl PCA logs. Based on this data we generated model of the random process that approximated real demand data and created 500 virtual PCA logs. These logs allowed pharmacokinetic simulation of the effect compartment concentration. The proposed methodology allows an estimation of frequency and duration of critical episodes, when target concentration exceeds critical threshold. These estimations might be used to evaluate patient specific risk of postoperative opiate overdose.
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