Inducción con propofol: infusión controlada por objetivo o manual. Un estudio observacional

Abstract

BackgroundTarget-controlled infusion (TCI) systems allow the administration of drug to achieve a target blood or site-effect concentration. We determine induction and recovery times and the amount of drug used with TCI systems vs. manual induction. ObjectiveTo determine whether the induction of propofol TCI and manual infusion are two comparable techniques. MethodsA retrospective observational study was conducted in which 62 ASAI-II patients scheduled for elective surgery received induction using TCI or manually. Anaesthetic induction was achieved with remifentanil (0.25μg/kg/min) and propofol (manual bolus injection: 2mg/kg, or target blood concentration: 5μg/ml with the TCI system [Marsh model]) with maintenance doses of remifentanil (0.15μg/kg/min) and propofol (manually 0.10mg/kg/min or 2.5-4μg/ml using the TCI system). In both groups, rocuronium bromide was used (induction and maintenance doses: 0.6 and 0.3mg/kg, respectively) as was morphine (0.1mg/kg) 45min before the end of the surgery.We measured: induction, operative and recovery mean times; bispectral index, heart rate, blood pressure, costs, haemodynamic instability, and intraoperative awareness. A telephone questionnaire was administered 1 month later. ResultsThe mean induction time was longer in the TCI than the manual group (1.76±0.94 vs. 0.9±0.4min; P<.001), but the total dose of propofol (TCI: 112.4±60.9 vs. manual: 133.8±80.3ml, P=.241) tended to be smaller and the recovery time was significantly shorter (TCI: 7.48±3.1 vs. manual: 10.3±4.9min) (P=.008). ConclusionsInduction with propofol using TCI is similar to manually delivered propofol.