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Individual titration of propofol plasma target improves anaesthetic stability in patients undergoing major abdominal surgery: a comparison with manually controlled infusion

Published online by Cambridge University Press:  01 September 2008

J. Mayer ,
J. Boldt ,
J. G. Triem ,
A. Schellhaaß ,
A. M. Mengistu  and
S. Suttner
J. Mayer*
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
J. Boldt
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
J. G. Triem
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
A. Schellhaaß
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
A. M. Mengistu
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
S. Suttner
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
*
Correspondence to: Jochen Mayer, Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstr. 79, 67063 Ludwigshafen, Germany. E-mail: j-mayer@gmx.de; Tel: +49 621 5030; Fax: +49 621 503 3024
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Summary

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.

Keywords

ANAESTHESIA INTRAVENOUS, total, target controlledSURGERY ABDOMINALPROPOFOLANAESTHESIA RECOVERY PERIODINFUSION PUMPS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 9 , September 2008 , pp. 741 - 747
Copyright
Copyright © European Society of Anaesthesiology 2008

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