Manual vs. target-controlled infusion induction with propofol: An observational study
Abstract
Background: Target-controlled infusion (TCI) systems allow the administration of drug to achieve a target blood or site-effect concentration. We determine induction and recovery times and the amount of drug used with TCI systems vs. manual induction. Objective: To determine whether the induction of propofol TCI and manual infusion are two comparable techniques.
Methods: A retrospective observational study was conducted in which sixty-two ASA I-II patients scheduled for elective surgery received induction using TCI or manually. Anaesthetic induction was achieved with remifentanil (0.25 μg/kg/min) and propofol (manual bolus injection: 2 mg/kg, or target blood concentration: 5 μg/ml with the TCI system [Marsh model]) with maintenance doses of remifentanil (0.15 μg/kg/min) and propofol (manually 0.10 mg/kg/min or 2.5-4 μg/ml using the TCI system). In both groups, rocuronium bromide was used (induction and maintenance doses: 0.6 and 0.3 mg/kg, respectively) as was morphine (0.1 mg/kg) 45 min before the end of the surgery.
We measured: induction, operative and recovery mean times; bispectral index, heart rate, blood pressure, costs, haemodynamic instability, and intraoperative awareness. A telephone questionnaire was administered 1 month later.
Results: The mean induction time was longer in the TCI than the manual group (1.76 ± 0.94 vs. 0.9 ±0.4 min; p < 0.001), but the total dose of propofol (TCI: 112.4 ±60.9 vs. manual: 133.8 ± 80.3 ml, p = 0.241) tended to be smaller and the recovery time was significantly shorter (TCI: 7.48 ±3.1 vs. manual: 10.3 ± 4.9 min) (p = 0.008).
Condusions: Induction with propofol using TCI is similar to manually delivered propofol
References
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