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We aimed to identify combinations of Ce<jats:sub>PROP<\/jats:sub> and Ce<jats:sub>REMI<\/jats:sub> along a single isobole of P<jats:sub>TOL<\/jats:sub> that result in favourable hypnotic and haemodynamic conditions. This knowledge could be of advantage in the development of drug advisory monitoring technology. 80 patients (18\u201390\u00a0years of age, ASA I\u2013III) were randomized into four groups and titrated towards Ce<jats:sub>PROP<\/jats:sub> (Schnider model, ug\u22c5ml<jats:sup>\u22121<\/jats:sup>) and Ce<jats:sub>REMI<\/jats:sub> (Minto model, ng\u22c5ml<jats:sup>\u22121<\/jats:sup>) of respectively 8.6 and 1, 5.9 and 2, 3.6 and 4 and 2.0 and 8. After eleven minutes of equilibration, baseline measurements of haemodynamic endpoints and bispectral index were compared with three minutes of responsiveness measurements after laryngoscopy. Before laryngoscopy, bispectral index differed significantly (p\u2009&lt;\u20090.0001) between groups in concordance with Ce<jats:sub>PROP<\/jats:sub>. Heart rate decreased with increasing Ce<jats:sub>REMI<\/jats:sub> (p\u2009=\u20090.001). The haemodynamic and arousal responses evoked by laryngoscopy were not significantly different between groups, but Ce<jats:sub>PROP<\/jats:sub>\u2009=\u20093.6\u00a0\u03bcg\u22c5ml<jats:sup>\u22121<\/jats:sup> and Ce<jats:sub>REMI<\/jats:sub>\u2009=\u20094\u00a0ng\u22c5ml<jats:sup>\u22121<\/jats:sup> evoked the lowest median value for \u2206HR and \u2206SAP after laryngoscopy. This study provides clinical insight on the haemodynamic and hypnotic consequences, when a model based predicted P<jats:sub>TOL<\/jats:sub> is used as a target for combined effect-site controlled target- controlled infusion of propofol and remifentanil. Heart rate and bispectral index were significantly different between groups despite a theoretical equipotency for P<jats:sub>TOL<\/jats:sub>, suggesting that each component of the anaesthetic state (immobility, analgesia, and hypnotic drug effect) should be considered as independent neurophysiological and pharmacological phenomena. However, claims of (in)accuracy of the predicted P<jats:sub>TOL<\/jats:sub> must be considered preliminary because larger numbers of observations are required for that goal.<\/jats:p>","DOI":"10.1007\/s10877-020-00540-9","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T16:23:15Z","timestamp":1591201395000},"page":"815-825","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of haemodynamic- and electroencephalographic-monitored effects evoked by four combinations of effect-site concentrations of propofol and remifentanil, yielding a predicted tolerance to laryngoscopy of 90%"],"prefix":"10.1007","volume":"35","author":[{"given":"J. P.","family":"van den Berg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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L.","family":"Scheeren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M. R. F.","family":"Struys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. E. M.","family":"Vereecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"540_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1093\/bja\/aew312","volume":"118","author":"JP van den Berg","year":"2017","unstructured":"van den Berg JP, Vereecke HE, Proost JH, Eleveld DJ, Wietasch JK, Absalom AR, Struys MM. Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current knowledge and how it can be used to optimize anaesthetic drug administration. 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Anesth Analg. 2019;128:265\u201377.","journal-title":"Anesth Analg"}],"container-title":["Journal of Clinical Monitoring and Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-020-00540-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10877-020-00540-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-020-00540-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T21:55:38Z","timestamp":1693518938000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10877-020-00540-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,3]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["540"],"URL":"https:\/\/doi.org\/10.1007\/s10877-020-00540-9","relation":{},"ISSN":["1387-1307","1573-2614"],"issn-type":[{"value":"1387-1307","type":"print"},{"value":"1573-2614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,3]]},"assertion":[{"value":"25 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"JPvdB, AMV, AFK, KvA, LNH, JHP, no competing interest declared.\u00a0HEMV: Received honoraria from Medasense Inc. (Tel Aviv, Israel) and Becton Dickinson (Eysins, Switzerland) for participation at an advisory board meeting. HEMV is member of the Scientific Subcommittee (General anaesthesia) of the European Society of Anaesthesiologists (ESA)\u00a0and vice-president of the International Society of Anaesthetic Pharmacology (ISAP).\u00a0SM: Received honoraria from Abbott Vascular (Hoofddorp, The Netherlands). Advisory board meeting from The Medicines Company (Parsippany, NJ, USA) for which his department received an honorarium. TWLS: received honoraria from Edwards Lifesciences (Irvine, CA, USA) and Masimo Inc. (Irvine, CA, USA) for consulting and lecturing and from Pulsion Medical Systems SE (Feldkirchen, Germany) for lecturing in the past. TWLS is associate editor of the Journal of Clinical Monitoring and Computing, but had no role in the handling of this manuscript. ARA: has performed paid consultancy work for Janssen Pharma, Carefusion, The Medicines Company and Ever Pharma (payment to institution). MMRFS: his research group\/department received grants and funding from The Medicines Company (Parsippany, NJ, USA), Masimo (Irvine, CA, USA), Fresenius (Bad Homburg, Germany), and honoraria from The Medicines Company (Parsippany, NJ, USA), Masimo (Irvine, CA, USA), Fresenius (Bad Homburg, Germany), Becton Dickinson (Eysins, Switzerland), and Demed Medical (Temse, Belgium).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the original study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}