[Propofol administration systems. Handling, hemodynamics and propofol consumption]

Area of Science:

• Anesthesiology
• Pharmacokinetics
• Medical Technology

Background:

• Propofol is commonly administered via manual controlled infusion (MCI) or target-controlled infusion (TCI) during anesthesia.
• Evaluating different TCI systems against MCI is crucial for optimizing anesthetic delivery, patient safety, and cost-effectiveness.

Purpose of the Study:

• To compare two distinct TCI systems (Schnider and Marsh models) with the MCI technique for propofol administration.
• To assess handling, patient safety, and cost implications of TCI versus MCI.

Main Methods:

• A prospective study involving 90 patients undergoing elective nasal surgery, randomly assigned to TCI-Schnider, TCI-Marsh, or MCI groups (n=30 each).
• Anesthesia depth was monitored using the bispectral index (BIS) adjusted to 40-55.
• Data collected included hemodynamics, extubation/awakening times, dose adjustments, drug consumption, costs, recovery quality, PONV, shivering, and patient satisfaction.

Main Results:

• No significant differences in demographics, hemodynamics, or initial propofol consumption (first 60 min) were observed.
• Both TCI groups showed significantly lower propofol consumption during extended anesthesia (>60 min) compared to MCI.
• The TCI-Schnider group exhibited fewer episodes of bradycardia; dose adjustment needs did not differ significantly between TCI groups.

Conclusions:

• Propofol administration via MCI or TCI under BIS monitoring is safe and manageable.
• TCI techniques result in reduced propofol consumption and potential cost savings for anesthesia procedures exceeding 60 minutes.
• No significant differences in extubation or awakening times were found between the methods.