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Propofol TCI

Youssef Motiaa, Mustapha Bensghir, Abdelhamid Jaafari, Mohammed Meziane, Redouane Ahtil, Noureddine Drissi Kamili
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay. METHODS: Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Han Bum Joe, Jong Yeop Kim, Hyun Jeong Kwak, Sang Eon Oh, Sook Young Lee, Sung Yong Park
BACKGROUND: Remifentanil can improve insertion of a laryngeal mask airway (LMA) during induction with propofol. Recently, it has been suggested that there is a sex difference in opioid requirements for this procedure. The purposes of this study were to determine the effective effect-site concentration (Ce) of remifentanil for the facilitation of LMA insertion in male and female patients during propofol anesthesia without neuromuscular blockade and to evaluate whether there are sex differences in the Ce of remifentanil required for successful LMA insertion...
September 2016: Medicine (Baltimore)
Claudia Claroni, Giulia Torregiani, Marco Covotta, Maria Sofra, Alessandra Scotto Di Uccio, Maria E Marcelli, Alessia Naccarato, Ester Forastiere
BACKGROUND: In many clinical conditions that involve free flaps and tissue transplantations the possibility of minimizing ischemia-reperfusion injury can be a determinant factor for the success of the surgery itself. We hypothesize that preconditioning with sevoflurane is a protective factor against ischemia-reperfusion injury. METHODS: In this randomized controlled trial, patients ASA I-II undergoing breast reconstruction with deep inferior epigastric perforator flaps were allocated into two groups and analyzed: group BAL included patients who received balanced anesthesia with sevoflurane for 30 min before removal of the flap and throughout the surgery...
2016: BMC Anesthesiology
Seung In Seo, Ji Yon Ryu, Sang Soo Kang, Jin Seo Lee, Hyoung Su Kim, Myoung Kuk Jang, Hak Yang Kim, Woon Geon Shin
BACKGROUND: A target-controlled infusion (TCI) of a propofol system uses a pharmacokinetic model to achieve and maintain a selected target blood propofol concentration. The aim of this study was to assess whether the propofol TCI system could be safely used by gastroenterologists in patients undergoing endoscopic resection including endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) compared with a manually controlled infusion (MCI) system. METHODS: A total of 431 patients undergoing therapeutic endoscopy (178 ESD and 253 EMR) were consecutively included from November 2011 to August 2014...
November 2016: Digestive Diseases and Sciences
Nicolas Louvet, Agnès Rigouzzo, Nada Sabourdin, Isabelle Constant
BACKGROUND: In children, only a few studies have compared different modes of propofol infusion during a total intravenous anesthesia (TIVA) with propofol and remifentanil. The aim of this study was to compare Bispectral Index (BIS) profiles (percentage of time spent at adequate BIS values) between four modes of propofol infusion: titration of the infusion rate on clinical signs (TIVA0 ), titration of the infusion rate on the BIS (TIVABIS ), target controlled infusion (TCI) guided by the BIS either with the Kataria model (TCI KBIS ) or the Schnider model (TCI SBIS )...
September 2016: Paediatric Anaesthesia
Jian-Yan Chen, Ming Yi, Shang-Long Yao, Xue-Ping Zhang
This study aimed to establish a new propofol target-controlled infusion (TCI) model in animals so as to study the general anesthetic mechanism at multi-levels in vivo. Twenty Japanese white rabbits were enrolled and propofol (10 mg/kg) was administrated intravenously. Artery blood samples were collected at various time points after injection, and plasma concentrations of propofol were measured. Pharmacokinetic modeling was performed using WinNonlin software. Propofol TCI within the acquired parameters integrated was conducted to achieve different anesthetic depths in rabbits, monitored by narcotrend...
June 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Guillaume Besch, Angeline Chopard-Guillemin, Elisabeth Monnet, Arnaud Causeret, Amelie Jurine, Gerald Baudry, Benjamin Lasry, Laurent Tavernier, Emmanuel Samain, Sebastien Pili-Floury
BACKGROUND: The ENDOTANIL trial aimed at comparing an association of target-controlled infusion (TCI) of remifentanil and propofol to TCI of propofol alone on the clinical conditions during pan endoscopy for assessment of the upper airway (pan endoscopy) performed under tubeless general anesthesia. METHODS: This double-blind, single center, parallel, randomized, placebo-controlled trial was conducted in a French tertiary level of care, from June 2009 to February 2013...
June 17, 2016: Minerva Anestesiologica
Daniel Franzen, Daniel J Bratton, Christian F Clarenbach, Lutz Freitag, Malcolm Kohler
BACKGROUND AND OBJECTIVE: Fractionated propofol administration (FPA) in flexible bronchoscopy (FB) may lead to oversedation and an increased risk of adverse events, because a stable plasma concentration of propofol is not maintainable. The purpose of this randomized noninferiority trial was to evaluate whether target-controlled infusion (TCI) of propofol is noninferior to FPA in terms of safety in FB. METHODS: Coprimary outcomes were the mean lowest arterial oxygen saturation (SpO2 ) during FB and the number of propofol dose adjustments in relation to procedure duration...
June 15, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Ali Khaqan, Muhammad Bilal, Muhammad Ilyas, Bilal Ijaz, Raja Ali Riaz
Maintaining the depth of hypnosis (DOH) during surgery is one of the major objectives of anesthesia infusion system. Continuous administration of Propofol infusion during surgical procedures is essential but increases the undue load of an anesthetist in operating room working in a multitasking setup. Manual and target controlled infusion (TCI) systems are not good at handling instabilities like blood pressure changes and heart rate variability arising due to interpatient variability. Patient safety, large interindividual variability, and less postoperative effects are the main factors to motivate automation in anesthesia...
2015: Computational and Mathematical Methods in Medicine
Xiaohua Wang, Tianlong Wang, Zhaolong Tian, David Brogan, Jingsheng Li, Yanhui Ma
BACKGROUND: Asleep-awake-asleep (AAA) protocol for epilepsy surgery is a unique opportunity to accurately map epilepsy foci involved in motor and eloquent areas, allowing the operator to optimize the resection. Two different application modes of intravenous anesthesia for AAA craniotomies are widely used: infusion by means of target-controlled infusion (TCI) and traditional manually-controlled infusion (MCI). We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be a more effective method than MCI in AAA epilepsy surgery...
August 2016: Journal of Clinical Anesthesia
Carlos Ramìrez-Paesano, Isaac Benjamin Fhima, Randolfo Medina, Maria Teresa Urbina, Carlos Martínez, Jorge Lerner Biber
OBJECTIVE: To evaluate efficacy of Propofol at Cp 2.5 µg/ ml administered by Target Controlled Infusion (TCI) using Marsh Modified Model, in pre-medicated with midazolam/ fentanil Latin-American women (Venezuelans) during oocyte retrieval for In Vitro Fertilization. METHODS: Prospective, descriptive study included 72 women, 18-44 years old, ASA I-II, non obese, undergoing oocyte retrieval, pre-medicated with midazolam 0.04 mg/kg and fentanil 2µg/kg and received anesthesia based in Propofol at Cp 2...
2015: JBRA Assisted Reproduction
Ren-Chih Huang, Nan-Kai Hung, Chueng-He Lu, Zhi-Fu Wu
After emergence from anesthesia, the incidence and severity of adverse airway effects caused by the laryngeal mask airway (LMA) can vary, depending on when the device was removed; nonetheless, reports differ regarding the exact optimal timing of LMA removal. The purpose of this study was to compare the rate of adverse events between 2 groups: those whose LMA was removed under general anesthesia ("deep" group) or under target-controlled infusion (TCI) of propofol ("awake" group).Institutional Review Board approval and written informed consent were obtained; 124 patients were then randomly allocated into either the "awake" group or the "deep" group...
April 2016: Medicine (Baltimore)
C Frederico Avendaño, L I Cortínez, C R Ramírez-Paesano
OBJECTIVE: To compare the Cortínez and Schnider models in effect-site TCI mode (3 mcg/ml) in healthy volunteers. METHODS: Ten healthy volunteers were prospectively studied on 2 occasions. Propofol was administered with the Cortínez or the Schnider models, as randomly assigned. Times and predicted concentrations at the time of loss and recovery of consciousness (LOC and ROC), mass of drug administered, BIS, and haemodynamic variables were compared. Statistical analysis was with paired Wilcoxon test...
April 23, 2016: Revista Española de Anestesiología y Reanimación
Tak Kyu Oh, Seung Jae Lee, Jae Hyun Kim, Boram Park, Woosik Eom
BACKGROUND: Radiation therapy requires the patient to remain immobile for a long time, which is challenging in children. This study therefore aimed to determine the adequate target concentration and dosage of propofol in target-controlled infusion (TCI) and manual infusion (MI) in children requiring sedation for proton radiation therapy. Our hypothesis is that the adequate dose of propofol sedation required for proton radiation therapy in pediatric patients was larger than that seen in previous studies...
2016: SpringerPlus
A Cattai, T Pilla, P Cagnardi, A Zonca, P Franci
The aim of this study was to develop and evaluate a pharmacokinetic model-driven infusion of propofol in premedicated cats. In a first step, propofol (10 mg/kg) was administered intravenously over 60 seconds to induce anaesthesia for the elective neutering of seven healthy cats, premedicated intramuscularly with 0.3 mg/kg methadone, 0.01 mg/kg medetomidine and 2 mg/kg ketamine. Venous blood samples were collected over 240 minutes, and propofol concentrations were measured via a validated high-performance liquid chromatography assay...
May 14, 2016: Veterinary Record
A W G Booth, K Vidhani
We conducted a retrospective audit of 285 adult elective microlaryngoscopy cases in our institution over a three-and-a-half year period. Conventional anaesthesia with intubation and mechanical ventilation was the most common technique, used in 71% of cases. Tubeless spontaneous ventilation during total intravenous anaesthesia with a target-controlled infusion of propofol (SVTCI) was the most common alternative. Spontaneous ventilation with target-controlled infusion was used for 79 (27.7%) anaesthetic inductions and was continued through the maintenance phase for 60 patients (21...
March 2016: Anaesthesia and Intensive Care
Sumidtra Prathep, Sasithorn Mahattanaporn, Wirat Wasinwong
BACKGROUND: Target-controlled infusion (TCI) systems have been developed from manually controlled infusion systems and have rapidly increased in popularity, especially in laparoscopic surgery. Propofol is claimed to decrease nausea and vomiting. OBJECTIVE: To compare anesthetic techniques, propofol-TCI, desflurane, and sevoflurane, for better results in terms of postoperative nausea and vomiting (PONV) and extubation times. MATERIAL AND METHOD: The present study was prospective with informed consent from 75 patients, ASA 1-3 scheduled for laparoscopic cholecystectomy, and classified by anesthetic technique into three groups...
December 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Aihua Jiang, Lin-Jing Chen, Yu-Xia Wang, Ming-Chuan Li, Yong-Bo Ding
AIM: To investigate the effects of methods of total intravenous anaesthesia (TIVA) and combined intravenous and inhaled anaesthesia (CIIA) for laparoscopic radical gastrectomy under the same anaesthetic depth monitored by entropy indices. PATIENTS AND METHODS: One hundred patients undergoing laparoscopic radical gastrectomy were randomly distributed into group I (anaesthetized by TIVA) and group II (anaesthetized by CIIA), each group including 50 patients. TIVA was performed with propofol and remifentanil by means of target controlled infusion (TCI) for the patients in group I...
March 2016: Anticancer Research
Ning Yang, Yun Yue, Jonathan Z Pan, Ming-Zhang Zuo, Yu Shi, Shu-Zhen Zhou, Wen-Ping Peng, Jian-Dong Gao
BACKGROUND: Bispectral index (BIS) is considered very useful to guide anesthesia care in elderly patients, but its use is controversial for the evaluation of the adequacy of analgesia. This study compared the BIS changes in response to loss of consciousness (LOC) and loss of somatic response (LOS) to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion (TCI) of propofol and remifentanil. METHODS: This study was performed on 52 elderly patients (aged 65-78 years) and 52 young patients (aged 25-58 years), American Society of Anesthesiologists physical status I or II...
February 20, 2016: Chinese Medical Journal
Po-Nien Chen, I-Cheng Lu, Hui-Ming Chen, Kuang-I Cheng, Kuang-Yi Tseng, King-Teh Lee
Whether low-concentration desflurane reinforces propofol-based intravenous anesthesia on maintenance of anesthesia for patients undergoing laparoscopic cholecystectomy is to be determined. The aim of this study was to investigate whether propofol-based anesthesia adding low-concentration desflurane is feasible for laparoscopic cholecystectomy. Fifty-two patients undergoing laparoscopic cholecystectomy were enrolled in the prospective, randomized, clinical trial. Induction of anesthesia was achieved in all patients with fentanyl 2 μg/kg, lidocaine 1 mg/kg, propofol 2 mg/kg, and rocuronium 0...
January 2016: Kaohsiung Journal of Medical Sciences
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