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Target controlled infusion of propofol for induction and maintenance of anaesthesia using the paedfusor: an open
Daphne A Varveris1, Neil S Morton
1Department of Anaesthesia, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
Insights
The Paedfusor device safely and effectively delivers propofol anesthesia in children over 6 months old for elective surgery. This computer-controlled infusion system demonstrated ease of use and maintained stable vital signs throughout procedures.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacokinetics
Background:
- Propofol is a common anesthetic agent.
- Computer-controlled infusion devices offer precise drug delivery.
- The Paedfusor is designed for pediatric anesthesia, accommodating children from 6 months and 5 kg.
Purpose of the Study:
- To evaluate the ease of use of the Paedfusor.
- To assess the clinical efficacy of the Paedfusor in pediatric patients.
- To determine the safety and adverse effects of the Paedfusor during anesthesia.
Main Methods:
- Thirty ASA I children (6 months to 16 years) undergoing elective surgery received anesthesia via the Paedfusor.
- Vital signs were monitored closely.
- Propofol plasma and effector site concentrations were recorded at key time points.
Main Results:
- A target plasma propofol level of 8 micro g/mL induced sleep within 1 minute.
- Spontaneous respiration was maintained in most patients; no laryngospasm occurred.
- Hemodynamic parameters remained stable, with vital signs within acceptable limits.
Conclusions:
- The Paedfusor is easy to use and clinically effective for pediatric anesthesia.
- The device demonstrated an absence of adverse effects in healthy children over 6 months.
- The Paedfusor is suitable for induction and maintenance of anesthesia in this pediatric population.
Background:
The aim of this study was to evaluate the ease of use and efficacy of the Paedfusor, a computer controlled propofol infusion device with software appropriate for children down to the age of 6 months and weighing 5 kg.
Methods:
Thirty ASA I children, aged 6 months to 16 years, who were scheduled for elective surgery, were anaesthetized using the Paedfusor, programmed for the child's age and weight. Vital signs were recorded at 1-min intervals during induction and every 3 min thereafter. Patients breathed spontaneously through a laryngeal mask airway (LMATM) and perioperative analgesia was provided by a regional block. Target plasma and calculated effector site propofol readings were recorded on insertion of the LMA, insertion of regional block, surgical incision and on removal of LMA.
Results:
A target plasma propofol level of 8 micro g.ml-1 universally induced sleep within 1 min. Spontaneous respiration was maintained in the majority of patients with no cases of laryngospasm. Mean calculated effector site concentration was 4.29 micro g.ml-1 for insertion of the LMA and 2.78 micro g.ml-1 for LMA removal. Fifty-seven percent moved on insertion of the local anaesthetic block and 30% responded to surgical stimulation. Mean heart rates increased slightly after each stimulus, returning thereafter to baseline values. Blood pressure remained stable. No relationship between the duration of infusion, total propofol requirements and time to patient awakening was found. The average total propofol dose was high, being highest in the youngest groups. Vital signs were within acceptable safety limits throughout.
Conclusions:
This open study confirms the ease of use, clinical efficacy and absence of adverse effects of the Paedfusor for the induction and maintenance of anaesthesia in healthy children aged over 6 months undergoing elective surgery.
