Evaluation of Automated Delivery of Propofol Using a Closed-Loop Anesthesia Delivery System in Patients Undergoing...

Area of Science:

• Anesthesiology
• Surgical Technology
• Pharmacology

Background:

• Automated propofol total intravenous anesthesia (TIVA) using closed-loop anesthesia delivery systems (CLADS) is more efficient than manual methods.
• However, CLADS application in major thoracic surgery remains limited.

Purpose of the Study:

• To evaluate the efficacy and safety of CLADS-driven propofol TIVA in patients undergoing thoracic surgery.
• To compare CLADS-TIVA with manual TIVA regarding anesthesia depth, delivery performance, propofol consumption, ergonomics, hemodynamics, and recovery.

Main Methods:

• Prospective, single-blind, randomized controlled study conducted at a single tertiary care center.
• Patients undergoing thoracic surgery were randomized to receive either CLADS-driven or manually controlled propofol TIVA.
• Anesthesia depth consistency, delivery performance metrics, propofol usage, work ergonomics, intraoperative hemodynamics, and recovery were analyzed.

Main Results:

• No significant differences were observed in anesthesia depth consistency or anesthesia delivery performance between CLADS and manual groups.
• Propofol requirements were significantly lower for both induction and maintenance in the CLADS group.
• CLADS-driven TIVA demonstrated a significant ergonomic advantage, with substantially fewer infusion adjustments compared to manual control.

Conclusions:

• In thoracic surgery, CLADS-automated propofol TIVA provides significant ergonomic benefits.
• CLADS-automated propofol TIVA also leads to reduced propofol usage.
• CLADS represents a valuable advancement for anesthesia management in thoracic procedures.