Check out the I-Manual page for an
interactive explanation of the current functions
What we are working on
30 Dec 2021 by Frank Engbers
These pages have not been updated for a while, but TivatrainerX
The team in Groningen, the Netherlands, produced models in recent years for propofol, remifentanl
that really could make TCI mature and an important instrument to support an anaesthetic-gas
When these models are implemented in all our TCI systems, anyone with appropriate training
could benefit from applying patient tailored drug dosing without worrying about the
complexity of pharmacokinetic pharmacodynamic modeling.
This includes anaesthesiologists, sedation practitioners, nurses, intensivists and other
persons that are certified to handle infusion devices.
But first we will have to get rid of the old confusing mess of models that were simply taken
from research publications and implemented in the past without proper clinical testing or
all population encompassing advanced simulations, and no suitable Summary of Product
Characteristics to inform the user on appropriate targets. But that is a different story to
be told later.
For the last two years or so I have been busy to incorporate the
above rather complex models into TivatrainerX including the sometimes even more complex
On the screenshot of tivatrainer on this page you see a simulation of dexmedetomidine using
the Hannivoort model with the different effect-site concentrations and in the upper part the
expected effects on heartrate, Mean arterial blood pressure, BIS and Modified Observer's
For propofol the expected effect, which is predominantly the Bispectral Index, is available
with the Eleveld2 model.
Clinicians are (unlike pharmacology researchers) not really interested in blood
concentrations but in the effect and side effects of a drug and dosing scheme.
By pasting the output from another model, using copy/paste, into this Eleveld2 model the
effect of other models and infusion schemes can be studied and the real clinical important
differences between models revealed.
Although simulations of blood concentration and 1 effect-site concentration can be saved in
an excel file it is not yet possible to save the Pd data. We will address this issue in the
coming platform independent version.
At the moment I am looking for possibilities to implement Remimazolam pharmacokinetics and
dynamics (if usable).