Individual titration of propofol plasma target improves anaesthetic stability in patients undergoing major abdominal surgery: a comparison with manually controlled infusion
| Autor: | Joachim Boldt, A. Schellhaass, Andinet Mengistu, J G Triem, John E. Mayer, Stefan W. Suttner |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Hemodynamics Blood Pressure law.invention Patient satisfaction Drug Delivery Systems Randomized controlled trial law Heart Rate Abdomen medicine Humans New device In patient Eyelash reflex Infusions Intravenous Propofol Digestive System Surgical Procedures Infusion Pumps Aged Aged 80 and over business.industry Titrimetry Electroencephalography Middle Aged Surgery Anesthesiology and Pain Medicine Treatment Outcome Anesthesia Anesthesia Intravenous Female business Anesthetics Intravenous Abdominal surgery medicine.drug |
| Zdroj: | European journal of anaesthesiology. 25(9) |
| ISSN: | 1365-2346 |
| Popis: | Background and objective The impact of anaesthesia using target-controlled infusion with propofol on intraoperative stability, recovery and cost compared to manually controlled infusion has been evaluated with inconsistent results. We studied a new device that allows more individual titration of propofol target-controlled infusion by using the effect-site concentration at the loss of eyelash reflex to predict the maintenance infusion rate (FM-TCI). Methods Fifty-six patients undergoing major abdominal surgery lasting >2 h were randomly assigned to receive either FM-TCI (n = 28) or MCI-controlled (n = 28) anaesthesia. Both groups were Bispectral Index-monitored and thoracic epidural analgesia was established. Anaesthetic stability, incidence of haemodynamic abnormalities, time to extubation, propofol consumption and patient satisfaction were assessed. Results In the FM-TCI group, a significantly improved anaesthetic stability was achieved (0.43 +/- 0.44 vs. 1.31 +/- 0.78 adjustments of propofol infusion per patient per hour, P = 0.003) and time to extubation was significantly shorter (9.6 +/- 2.1 vs. 15.7 +/- 9.6 min P = 0.011). With FM-TCI, propofol consumption was significantly lower. Haemodynamic stability and patient satisfaction did not differ between the groups. Conclusion FM-TCI helps to provide more stable anaesthesia conditions requiring less-frequent adjustments of the propofol infusion compared to manually controlled infusion in patients undergoing major abdominal surgery. |
| Databáze: | OpenAIRE |
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