Two distinct application habits for propofol: an observational study

Abstract

In total intravenous anaesthesia, two different application modes for propofol are widely used: infusion by means of manually controlled infusion pumps, and infusion by means of microprocessor-controlled infusion pumps operating according to pharmacokinetic algorithms (target controlled infusion, TCI). The parallel use of these two methods in our department by various anaesthetists offered the opportunity to retrospectively compare both application patterns regarding clinical effects and drug consumption. Ninety-six anaesthesia records from general anaesthesias with propofol and opioids from gynaecological laparoscopic operations were retrospectively evaluated. Forty-eight records were derived from six anaesthetists using manual propofol infusion (retrospective allocation to group C) and 48 other records from six anaesthetists using TCI infusion (retrospective allocation to group M). We assessed the intraoperative haemodynamic course, drug consumption, awakening time and postoperative side effects. The awakening time after TCI was significantly shorter than after manual propofol infusion (M: 4.9 +/- 3.1 min vs. C: 9.9 +/- 5.7 min). We observed a nonsignificantly rarer occurrence of postoperative side effects such as postoperative nausea and vomiting and pain. Only insignificant differences in drug consumption could be found. Both observed application patterns for propofol showed similar clinical profiles. Using TCI, awakening time was 5 min earlier than with manual infusion mode, thus showing a potential pharmaco-economical advantage in anaesthesias for gynaecological laparoscopy. The detected differences did not have a statistically significant influence on the early postoperative outcome.