Evaluation of a novel closed-loop total intravenous anaesthesia drug delivery system: a randomized controlled trial
| Autor: | Riccardo Taddei, Mohamad Wehbe, Erik Arbeid, C. Zaouter, Thomas M. Hemmerling, Shantale Cyr |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Remifentanil System a law.invention Drug Delivery Systems Piperidines Randomized controlled trial law medicine Humans Rocuronium Propofol Aged business.industry Electroencephalography Middle Aged Confidence interval Surgery Anesthesiology and Pain Medicine Anesthesia Bispectral index Anesthesia Intravenous Female Total intravenous anaesthesia Analgesia business medicine.drug |
| Zdroj: | British Journal of Anaesthesia. 110:1031-1039 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aet001 |
| Popis: | We have developed an automatic anaesthesia system for closed-loop administration of anaesthesia drugs. The control variables used were bispectral index (BIS) and Analgoscore for hypnosis and antinociception, respectively.One hundred and eighty-six patients were randomly enrolled in two groups. Propofol, remifentanil, and rocuronium were administered using closed-loop feedback control (closed-loop, n = 93) or manually (control group, n = 93). The clinical performance of hypnosis control was determined by calculating the offset from a BIS of 45: 'excellent', 'good', 'poor', and 'inadequate' control was defined as BIS values within 10%, from 11% to 20%, from 21% to 30%, or30% offset from the target. The clinical performance of analgesia was defined as the offset from Analgoscore values. Data presented as mean (standard deviation) (95% confidence interval).Excellent or good control of hypnosis was achieved significantly longer in the closed-loop group [47.0 (9.8%) (45.0/49.0), 34.4 (4.7%) (33.5/35.4)] than in the control group [37.3 (14.3%) (34.4/40.2) and 32.3 (7.6%) (30.7/33.7)], respectively (P0.0001 and 0.0085). Poor and inadequate control of hypnosis was significantly shorter in the closed-loop group [10.8 (5.0%) (9.8/11.8) and 7.7 (6.2%) (6.4/9.0)] than in the control group [14.7 (6.8%) (13.3/16.0) and 15.8 (14.7%) (12.8/18.8)], respectively (P0.0001). Excellent control of analgesia was achieved significantly longer in the closed-loop group [78.7 (16.2%) (75.4/82.0)] than in the control group [73.7 (17.8%) (70.1/77.3)] (P=0.0456).The closed-loop system was better at maintaining BIS and Analgoscore than manual administration. |
| Databáze: | OpenAIRE |
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