Pharmacokinetic–pharmacodynamic population modelling in paediatric anaesthesia and its clinical translationMorse, James D.a; Hannam, Jacquelinea; Anderson, Brian J.bCurrent Opinion in Anesthesiology: June 2019 - Volume 32 - Issue 3 - p 353–362 doi: 10.1097/ACO.0000000000000725 PEDIATRIC ANESTHESIA: Edited by Tom G. Hansen Buy SDC Abstract Author InformationAuthors Article MetricsMetrics Purpose of review Pharmacokinetic–pharmacodynamic (PKPD) population modelling has advanced adult anaesthesia. Current literature was reviewed to discern use of this analytic technique for benefit in the perioperative management of children. Recent findings Variability in drug response, selection of a dose that achieves a desired target concentration and optimizing sampling protocols for further studies are all facets of paediatric anaesthesia that have benefitted from modelling approaches. PKPD models have driven the maintenance dose rate in target-controlled infusion pumps used for total intravenous anaesthesia. Although many of the models used in these pumps were developed in adults, translation for paediatric use has followed, including subgroups, such as neonates and obese children. The use of drug effect measures (e.g. bispectral index) has improved the predictive performance of pharmacodynamic models. Simulation studies have facilitated an increase in safety by quantifying drug variability, and identifying where possible adverse drug events may occur. Summary Modelling and simulation continue to have an important role optimizing drug use during anaesthesia. Models incorporating influential covariates that better describe drug pharmacokinetics and pharmacodynamics improve anaesthetic treatments and safety in diverse populations and clarify drug role and impact. Their use developing paediatric clinical studies improves trial conduct, often with fewer subjects required for study. aDepartment of Pharmacology & Clinical Pharmacology bDepartment of Anaesthesiology, University of Auckland, New Zealand Correspondence to Brian J. Anderson, C/- PICU, Auckland Children's Hospital, Park Road, Auckland, New Zealand. Tel: +64 9 3074903; fax: +64 9 3078986; e-mail: firstname.lastname@example.org Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved.