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Comparison of target-controlled infusion and manual infusion for propofol anaesthesia in children

J Mu1, T Jiang1, X B Xu1

  • 1Department of Anaesthesiology, University of Hong Kong Shenzhen Hospital, Shenzhen, China.

British Journal of Anaesthesia
|April 18, 2018
PubMed

Insights

Target-controlled infusion (TCI) for propofol anesthesia in children did not prolong recovery time compared to manual infusion. TCI also improved the time spent within the target Bispectral Index (BIS) range.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacokinetics

Background:

  • Prolonged propofol-based total intravenous anesthesia (TIVA) in children is associated with extended recovery times.
  • Target-controlled infusion (TCI) may offer better control over propofol dosage and potentially shorten recovery.
  • This study compares TCI with manual infusion for propofol administration in pediatric patients.

Purpose of the Study:

  • To evaluate the efficacy of TCI versus manual infusion for propofol administration in children.
  • To determine if TCI reduces propofol dosage and shortens recovery time.
  • To assess the impact of TCI on maintaining the desired Bispectral Index (BIS) range.

Main Methods:

  • Children aged 1-12 years (ASA grade 1) were randomized to TCI or manual propofol infusion.
  • Propofol infusion rates were adjusted to maintain BIS between 40 and 60.
  • Recovery time, propofol dose, and time within the target BIS range were recorded.

Main Results:

  • No significant difference in tracheal extubation time was observed between TCI and manual infusion groups (15.1 vs 16.2 min, P=0.42).
  • The TCI group received a higher mean propofol infusion rate (16.7 vs 14.6 mg kg⁻¹ h⁻¹, P=0.036).
  • The TCI group spent a significantly greater percentage of time with BIS between 40 and 60 (10.2% vs 23.2%, P=0.016).

Conclusions:

  • TCI use in children resulted in higher propofol doses but did not prolong recovery time compared to manual infusion.
  • TCI provided better control, with a greater percentage of time within the target BIS range.
  • TCI may be a more effective method for titrating propofol during pediatric anesthesia or sedation.
Abstract

Keywords:
childrenemergence deliriumtotal i.v. anaesthesia

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