Abstract PR244

Abstract

Background & Objectives: Total intravenous anaesthesia (TIVA) with target controlled infusion (TCI) of propofol in children reduces emergence delirium, postoperative nausea and vomiting, laryngospasm and pain1. Despite this, it is not often used. One major criticism is prolonged recovery time 2. Since TCI obviates the need to manually adjust infusion rate, the use of TCI to deliver propofol in children may shorten recovery time and reduce propofol dose. The goal of this study was to determine whether TCI reduces time to extubation and recovery of consciousness after TIVA. Materials & Methods: Children with ASA 1, aged 1- 12 years undergoing surgery requiring endotracheal intubation were recruited and randomly assigned to TCI or manual propofol infusion. Children in the TCI group had propofol delivered by TCI using the Paedifusor PK model starting at 5 mcg.ml-1 at induction. Children for manual infusion had a loading dose of 2.5mg.kg-1, with subsequent infusion at 15-13-11-10-9 mg.kg.hr-1 3. Bispectral index™ was used to guide propofol dose. The attending anaesthesiologist adjusted the TCI or manual infusion as necessary according to maintain BIS between 40-60. Results: To date 62 children have been recruited and 59 have completed the study. There was no difference in extubation time, but the children in the TCI group had significantly longer time to eye opening and time to obeying commands (table 1). The TCI group had significantly more propofol. Remifentanil consumption between the two groups was similar (table 1).Table 1.: Value in mean+/-SD or Number (%)Conclusion: Discussion Use of TCI lead to higher propofol doses and prolonged recovery time in children compared to manual infusion.