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Propofol TCI

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https://www.readbyqxmd.com/read/29720751/effect-site-concentration-of-propofol-at-induction-and-recovery-of-anaesthesia-a-correlative-dose-response-study
#1
Vasanth Sukumar, Arathi Radhakrishnan, Venkatesh H Keshavan
Background and Aims: Sound knowledge about effect site concentration (Ce) of propofol aids in smooth induction, maintenance and early recovery. We studied the correlation between Ce of propofol at loss of response to verbal command and recovery concentration using target-controlled infusion (TCI) in Indian patients who underwent spine surgeries. Methods: Ninety patients undergoing spine surgeries were included. Total intravenous anaesthesia (TIVA) technique with TCI for propofol using modified Marsh model was used...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29684039/development-and-validation-of-brain-target-controlled-infusion-of-propofol-in-mice
#2
Brenna P Shortal, Sarah L Reitz, Adeeti Aggarwal, Qing C Meng, Andrew R McKinstry-Wu, Max B Kelz, Alex Proekt
Mechanisms through which anesthetics disrupt neuronal activity are incompletely understood. In order to study anesthetic mechanisms in the intact brain, tight control over anesthetic pharmacology in a genetically and neurophysiologically accessible animal model is essential. Here, we developed a pharmacokinetic model that quantitatively describes propofol distribution into and elimination out of the brain. To develop the model, we used jugular venous catheters to infuse propofol in mice and measured propofol concentration in serial timed brain and blood samples using high performance liquid chromatography (HPLC)...
2018: PloS One
https://www.readbyqxmd.com/read/29661412/pharmacokinetic-pharmacodynamic-model-for-propofol-for-broad-application-in-anaesthesia-and-sedation
#3
D J Eleveld, P Colin, A R Absalom, M M R F Struys
BACKGROUND: Pharmacokinetic (PK) and pharmacodynamic (PD) models are used in target-controlled-infusion (TCI) systems to determine the optimal drug administration to achieve a desired target concentration in a central or effect-site compartment. Our aim was to develop a PK-PD model for propofol that can predict the bispectral index (BIS) for a broad population, suitable for TCI applications. METHODS: Propofol PK data were obtained from 30 previously published studies, five of which also contained BIS observations...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661382/comparison-of-target-controlled-infusion-and-manual-infusion-for-propofol-anaesthesia-in-children
#4
J Mu, T Jiang, X B Xu, V M Yuen, M G Irwin
BACKGROUND: One major criticism of prolonged propofol-based total i.v. anaesthesia (TIVA) in children is the prolonged recovery time. As target-controlled infusion (TCI) obviates the need to manually calculate the infusion rate, the use of TCI may better match clinical requirements, reduce propofol dose, and shorten recovery time. METHODS: Children of ASA grade 1, aged 1-12 yr, were recruited and randomly assigned to TCI or manual infusion. Children in the TCI group had propofol delivered by TCI...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29599632/comparison-of-the-effects-of-dexmedetomidine-on-the-induction-of-anaesthesia-using-marsh-and-schnider-pharmacokinetic-models-of-propofol-target-controlled-infusion
#5
Wan Mohd Nazaruddin Wan Hassan, Hai Siang Tan, Rhendra Hardy Mohamed Zaini
Background: The study aimed to determine the effects of dexmedetomidine on the induction of anaesthesia using different models (Marsh and Schnider) of propofol target-controlled infusion (TCI). Methods: Sixty-four patients aged 18-60 years, American Society of Anaesthesiologists (ASA) class I-II who underwent elective surgery were randomised to a Marsh group ( n = 32) or Schnider group ( n = 32). All the patients received a 1 μg/kg loading dose of dexmedetomidine, followed by TCI anaesthesia with remifentanil at 2 ng/mL...
February 2018: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29579636/determination-of-dexmedetomidine-by-uhplc-ms-ms-and-its-application-to-evaluate-the-effect-of-dexmedetomidine-concentration-on-the-target-controlled-infusion-concentration-of-propofol
#6
Zhuoling Zheng, Shuyu Zhang, Wudi Ma, Lingyi Zhang, Ling Huang, Wenqi Huang, Min Huang, Zhongxing Wang, Jiali Li
The combination of dexmedetomidine (DEX) and propofol (PPF) is extensively used in the field of anaesthesiology. This study aimed to develop and validate a rapid, simple and sensitive ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the determination of DEX in human plasma. The method was applied to evaluate the effect of DEX concentration on the target-controlled infusion (TCI) concentration of PPF. Analytes were separated on a Waters XTERRA® MS C18 column with a mobile phase of acetonitrile-methanol-water containing 0...
May 30, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29401079/effect-site-target-controlled-infusion-in-the-obese-model-derivation-and-performance-assessment
#7
Luis I Cortínez, Pablo Sepúlveda, Augusto Rolle, Pauline Cottin, Alexandre Guerrini, Brian J Anderson
BACKGROUND: The aim of this study is to derive a propofol pharmacokinetic (PK) pharmacodynamic (PD) model to perform effect-site target-controlled infusion (TCI) in obese patients, and to analyze its performance along with that of other available PK models. METHODS: In the first step of the study, a 3-compartment PK model linked to a sigmoidal inhibitory Emax PD model by a first-order rate constant (keo) was used to fit propofol concentration-bispectral index (BIS) data...
February 2, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29386974/target-controlled-infusion-propofol-versus-sevoflurane-anaesthesia-for-emergency-traumatic-brain-surgery-comparison-of-the-outcomes
#8
Wan Mohd Nazaruddin Wan Hassan, Yusnizah Mohd Nasir, Rhendra Hardy Mohamad Zaini, Wan Fadzlina Wan Muhd Shukeri
Background: The choice of anaesthetic techniques is important for the outcome of traumatic brain injury (TBI) emergency surgery. The objective of this study was to compare patient outcomes for target-controlled infusion (TCI) of propofol and sevoflurane anaesthesia. Methods: A total of 110 severe TBI patients, aged 18-60, who underwent emergency brain surgery were randomised into Group T (TCI) ( n = 55) and Group S (sevoflurane) ( n = 55). Anaesthesia was maintained in Group T with propofol target plasma concentration of 3-6 μg/mL and in Group S with minimum alveolar concentration (MAC) of sevoflurane 1...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29349348/the-effect-of-tulobuterol-patches-on-the-respiratory-system-after-endotracheal-intubation
#9
Do-Won Lee, Eun-Soo Kim, Wang-Seok Do, Han-Bit Lee, Eun-Jung Kim, Cheul-Hong Kim
Background: Endotracheal intubation during anesthesia induction may increase airway resistance (Raw ) and decrease dynamic lung compliance (Cdyn ). We hypothesized that prophylactic treatment with a transdermal β2-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube. Methods: Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each)...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29315660/precision-and-bias-of-target-controlled-prolonged-propofol-infusion-for-general-anesthesia-and-sedation-in-neurosurgical-patients
#10
Andrea Cortegiani, Alessandra Pavan, Fabio Azzeri, Giuseppe Accurso, Filippo Vitale, Cesare Gregoretti
The aim of this study was to determine the relationship, precision, and bias of a propofol target-controlled infusion (TCI) system during prolonged infusion in neurosurgical patients. We retrospectively included patients undergoing general anesthesia for elective neurosurgical removal of brain tumors and postoperative sedation in the intensive care unit over a period of 3 months. TCI of propofol (Diprifusor - Marsh model) and remifentanil were used for general anesthesia and sedation. We compared propofol blood concentration (Cmeas ) measured by liquid chromatography-mass spectroscopy with predicted concentrations (Cpred ) by the TCI system at 40 minutes (T0), 2 hours (T1), and 4 hours (T2) and every 8 hours after starting the drug infusion and at the time of emergence from sedation...
January 9, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29231349/-effect-of-ear-point-embedding-on-plasma-and-effect-site-concentrations-of-propofol-remifentanil-in-elderly-patients-after-target-controlled-induction
#11
Xiaochun Zheng, Liling Wan, Fei Gao, Jianghu Chen, Wenshao Tu
OBJECTIVE: To observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS). METHODS: Fifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one...
August 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#12
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29129867/a-non-invasive-monitoring-of-propofol-concentration-in-blood-by-a-virtual-surface-acoustic-wave-sensor-array
#13
Fengjiang Zhang, Hao Dong, Xuanlang Zhang, Jin Guo, Yunqing Liu, Cheng Zhou, Xi Zhang, Jun Liu, Min Yan, Xing Chen
Propofol (2,6-diisopropylphenol) is widely used in total intravenous anesthesia. An unknown drug concentration in blood always leads to some side effects in patients with propofol injection. However, the drug concentration in the blood is hard to be continuously measured since invasive sampling causes a loss of blood at each measurement. Here, we introduced a virtual surface acoustic wave sensor array (VSAWSA) to non-invasively detect the propofol concentration in blood through exhaled gases. Calibration was conducted by a parallel test using gas chromatography and mass spectrometry (GC-MS) with solid-phase micro-extraction (SPME) for preconcentration...
2017: Analytical Sciences: the International Journal of the Japan Society for Analytical Chemistry
https://www.readbyqxmd.com/read/29104660/target-controlled-infusion-of-propofol-and-remifentanil-combined-with-dexmedetomidine-reduces-functional-endoscopic-sinus-surgery-bleeding
#14
Deng-Feng Ding, Li-Fang Wu, Ping Wang, Yuan-Xu Jiang, Yao-Wen Luo, Zhong-Liang Dai, Xue-Ping Zhang, Ya-Li Li
The aim of the present study was to investigate the effects of target-controlled infusion (TCI) of propofol and remifentanil combined with dexmedetomidine on functional endoscopic sinus surgery (FESS) bleeding and surgical field. 62 patients scheduled to undergo FESS were randomly divided into experimental group (intravenous 0.5 µg kg-1 h-1 dexmedetomidine after 0.5 µg kg-1 bolus within 15 min until the end of surgery) or control group (intravenous saline administration at the same dose). All patients underwent endotracheal intubation under general anesthesia with TCI of propofol and remifentanil for anesthesia induction and maintenance...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29028925/influence-of-bayesian-optimization-on-the-performance-of-propofol-target-controlled-infusion
#15
J P van den Berg, D J Eleveld, T De Smet, A V M van den Heerik, K van Amsterdam, B J Lichtenbelt, T W L Scheeren, A R Absalom, M M R F Struys
Background: Target controlled infusion (TCI) systems use population-based pharmacokinetic (PK) models that do not take into account inter-individual residual variation. This study compares the bias and inaccuracy of a population-based vs a personalized TCI propofol titration using Bayesian adaptation. Haemodynamic and hypnotic stability, and the prediction probability of alternative PK models, was studied. Methods: A double-blinded, prospective randomized controlled trial of 120 subjects undergoing cardiac surgery was conducted...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28886612/-remifentanil-up2date-part-2
#16
Stefan Bushuven, Sascha Kreuer, Peter Kranke
Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with propofol it is used for target controlled infusion (TCI). The second part of the article shows the differences between groups of patients regarding the use of remifentanil.
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28865915/anaesthetic-depth-control-using-closed-loop-anaesthesia-delivery-system-vs-target-controlled-infusion-in-patients-with-moderate-to-severe-left-ventricular-systolic-dysfunction
#17
V Mahajan, T Samra, G D Puri
OBJECTIVES: To compare the efficacy of anaesthetic depth control using Closed Loop Anaesthesia Delivery System (CLADS) and Target Controlled Infusion (TCI) in patients with moderate to severe left ventricular dysfunction (LVSD). DESIGN: Randomized control trial. PATIENTS: Forty ASA III/IV adult patients with moderate to severe LVSD scheduled for open heart surgery. INTERVENTIONS: Propofol was administered using CLADS or TCI for maintaining BIS of 50...
November 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#18
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28743151/-remifentanil-up2date-part-1
#19
Stefan Bushuven, Sascha Kreuer, Peter Kranke
Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with Propofol it is used for target-controlled infusion (TCI). The first part of the article provides readers with information about historical aspects, pharmacological characteristics, effects and side effects of remifentanil...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28672136/comparison-of-changes-in-respiratory-dynamics-immediately-after-the-start-of-propofol-sedation-with-or-without-midazolam
#20
Ayano Hagiwara, Nobuyuki Matsuura, Tatsuya Ichinohe
PURPOSE: The aim of this study was to compare changes in respiratory dynamics starting immediately after administration of propofol alone or a combination of propofol and midazolam. MATERIALS AND METHODS: Twenty-seven healthy adult volunteers participated in a randomized crossover study of undergoing sedation with propofol alone (P group) or with a combination of propofol and midazolam (PM group). In the P group, continuous infusion of propofol through a target-controlled infusion (TCI) pump was started with the target effect site (ES) concentration set at 1...
January 2018: Journal of Oral and Maxillofacial Surgery
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