Anaes Vivas · Intravenous induction agents
Data viva — the three-compartment model of propofol
A Primary/Final data viva — interpret the three-compartment model of propofol. Explain V1/V2/V3 and the rate constants (k12, k21, k13, k31, k10); why onset is one arm-brain circulation; why recovery after a bolus is redistribution-driven (about 10 minutes); why the high clearance (1.5 to 2 L/min) and the modestly rising context-sensitive half-time make propofol the agent of TIVA and TCI; and how EEG depth monitoring closes the loop.
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A diagram of the three-compartment pharmacokinetic model for propofol. The central compartment V1 (the plasma and the vessel-rich group of well-perfused organs, including the brain) is the compartment into which the drug is delivered and in which the effect is generated. It is connected to a rapidly equilibrating peripheral compartment V2 (muscle) by the rate constants k12 (out of V1) and k21 (back into V1), and to a slowly equilibrating peripheral compartment V3 (fat) by k13 (out) and k31 (back). Elimination, by hepatic and extrahepatic metabolism, occurs from V1 via the rate constant k10. Interpret the diagram and explain how it accounts for the rapid onset, the rapid recovery after a single bolus, and the use of propofol as a maintenance infusion.
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