Correspondence  |   August 2018
Pharmacokinetic Pharmacodynamic Perspective on the Detection of Signs of Neural Inertia in Humans
Author Notes
  • University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, and Ghent University, Ghent, Belgium (P.J.C.). j.colin@umcg.nl
  • (Accepted for publication May 7, 2018.)
    (Accepted for publication May 7, 2018.)×
Article Information
Correspondence
Correspondence   |   August 2018
Pharmacokinetic Pharmacodynamic Perspective on the Detection of Signs of Neural Inertia in Humans
Anesthesiology 8 2018, Vol.129, 373-375. doi:10.1097/ALN.0000000000002287
Anesthesiology 8 2018, Vol.129, 373-375. doi:10.1097/ALN.0000000000002287
We read with great interest the paper, “Investigation of Slow-wave Activity Saturation during Surgical Anesthesia Reveals a Signature of Neural Inertia in Humans” by Warnaby et al.1  The authors claim to have found experimental evidence for neural inertia in humans on the basis of a difference in the modeled slow-wave activity between induction and emergence from propofol anesthesia. As the authors state, until recently, neural inertia has only been observed in animals,2  and evidence was lacking on the importance of this phenomenon in humans.
In parallel to Warnaby et al., our group recently conducted a clinical study to investigate this phenomenon in healthy volunteers.3  Our analysis suggested, among other things, that the ability to detect signs of neural inertia depends on the design of the study. Inspired by the work of Warnaby et al., we would like to show how the drug titration scheme may influence the detection of neural inertia and could lead to false positive results.