| Autor: |
Shagun B. Shah, Rajiv Chawla, Manish Gupta |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
Journal of Anaesthesiology Clinical Pharmacology, Vol 40, Iss 1, Pp 114-119 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
0970-9185 |
| DOI: |
10.4103/joacp.joacp_269_22 |
| Popis: |
Background and Aims: Empirically adjusted, standard drug doses fail to address interindividual pharmacokinetic and pharmacodynamics variability. Target-controlled infusion (TCI) delivers drugs in calibrated boluses to achieve and maintain a selected target plateau drug level (plasma or effect site). Interactive total intravenous anesthesia (iTIVA™) smartphone software simulates TCI and employs 31 established pharmacokinetic models for 11 different intravenous agents and is coupled with standard volumetric infusion pumps for administering TCI. Material and Methods: This prospective, observational, study investigates the degree of agreement between iTIVA and a conventional TCI pump (CTP) for the volume of propofol infused using the Schnider pharmacokinetic model in adult patients of either sex undergoing oncosurgery lasting 1–3 h under total intravenous anesthesia. Bland–Altman analysis of 124 data pairs from 30 patients provided bias, precision, and limits of agreement between the volumes infused by CTP and iTIVA (V-CTP and V-iTIVA) during specific identical time periods. Spearman’s rho and Kendall’s tau rank correlation coefficients provided the degree of association between V-CTP and V-iTIVA. Results: Spearman’s rho and Kendall’s tau were 0.996 and 0.964, respectively. Bias or the mean of differences was −0.02, while the limits of agreement were 0.58 and −0.63, respectively (Bland–Altman plot). The maximum allowed difference of 2 ml was much larger than the 95% confidence intervals for the limits of agreement. The Mountain plot was short tailed (−1.28 to 1.55) and centred over zero (0.01). Conclusion: The volume of propofol infused using TCI pump was similar to that calculated by iTIVA in identical time periods, confirming the clinical applicability of iTIVA. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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