Lugo-Goytia G, Esquivel V, Gutiérrez H, Hernández-Rayón A

Language: English
References: 17
Page: 20-26
PDF size: 68.53 Kb.

ABSTRACT

This study was designed to compare the clinical performance of an effect-site target-controlled infusion (TCI) system versus a manually controlled infusion (MCI) system in 19 ASA I/II patients undergoing laparoscopic surgery. Patients were randomly assigned to receive TIVA with propofol by either a MCI or TCI system. Besides propofol, patients in both groups received a continuous fentanyl infusion to maintain a constant target concentration of 1.5 ng/ml. Propofol infusion rate or propofol target effect-site concentration were titrated to maintain an adequate anesthetic depth, defined as mean arterial pressure and heart rate within 20% of baseline values, plus absence of somatic and autonomic signs. Use of TCI resulted in more rapid induction of anesthesia, but requiring significantly greater propofol doses. However, the overall rate of propofol administration was significantly lower with the TCI system. Superior hemodynamic control was achieved with the TCI than with the MCI system. Times to eye opening and orientation were slightly but significantly shorter in the TCI group. Control over the depth of anesthesia was easier and more precise with the TCI system. The time for patients to fulfill the criteria for discharge from the PACU was similar with both systems. It is concluded that both systems provided acceptable clinical anesthetic conditions, with a rapid and predictable recovery. However, an effect-site TCI system offers the advantage of an easier and more precise control to modify the depth of anesthesia, better hemodynamic stability, and a slight reduction in overall propofol consumption.

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