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Computer controlled infusion of propofol.

R M Tackley1, G T Lewis, C Prys-Roberts

  • 1Department of Medical Physics, Bristol Royal Infirmary.

British Journal of Anaesthesia
|January 1, 1989
PubMed
Summary
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Computer-controlled propofol infusion achieved target blood concentrations in spontaneously breathing patients. Artificially ventilated patients had higher propofol levels, indicating altered pharmacokinetics during mechanical ventilation.

Area of Science:

  • Anesthesiology
  • Pharmacokinetics
  • Medical Devices

Background:

  • Propofol is a widely used anesthetic agent.
  • Accurate drug delivery is crucial for patient safety and effective anesthesia.
  • Computer-controlled infusion pumps offer precise drug administration.

Purpose of the Study:

  • To evaluate the accuracy of a computer-controlled infusion system for propofol delivery.
  • To compare propofol blood concentrations between spontaneously breathing and artificially ventilated patients.
  • To assess the influence of ventilation mode on propofol pharmacokinetics.

Main Methods:

  • Two groups of eight patients undergoing body surface surgery received propofol via a computer-controlled pump.
  • Anesthesia was supplemented with nitrous oxide and oxygen; morphine sulfate was used for premedication.

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  • Group 1 breathed spontaneously; Group 2 underwent artificial ventilation to maintain normal PaCO2.

    • Main Results:

    • The computer program aimed to rapidly achieve and maintain a target propofol blood concentration of 3 µg/mL.
    • In spontaneously breathing patients (Group 1), mean blood propofol concentrations closely matched predictions from 10 to 120 minutes.
    • Artificially ventilated patients (Group 2) exhibited 5-20% higher propofol concentrations from 20 minutes onwards compared to predictions.

    Conclusions:

    • Computer-controlled propofol infusion effectively achieves target blood concentrations in spontaneously breathing surgical patients.
    • Artificial ventilation significantly alters propofol pharmacokinetics, leading to higher-than-predicted blood concentrations.
    • Further research is needed to refine pharmacokinetic models for artificially ventilated patients.