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Article: A comparison of two techniques for induction of anaesthesia with target-controlled infusion of propofol

TitleA comparison of two techniques for induction of anaesthesia with target-controlled infusion of propofol
Authors
KeywordsGeneral anaesthesia
Propofol
Target-controlled infusion
Titration
Issue Date2018
PublisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044
Citation
Anaesthesia, 2018, v. 73 n. 12, p. 1507-1514 How to Cite?
AbstractInduction of anaesthesia with target-controlled infusion of propofol may be achieved by stepwise increases in effect-site concentration until the patient loses consciousness (titration method), or by setting a high effect-site concentration target and observing the calculated effect-site concentration at loss of consciousness (standard method). When the estimated effect-site concentration at loss of consciousness is accurate, the difference between effect-site concentration at loss of consciousness and at recovery of consciousness should be small. This prospective, randomised, controlled trial was designed to compare this difference (effect-site concentration at loss of consciousness - effect-site concentration at recovery of consciousness) associated with the two techniques. Sixty-seven healthy patients undergoing elective hemithyroidectomy were recruited. Induction of anaesthesia was achieved using effect-site target-controlled infusion with the modified Marsh model and ke0 of 1.2 min-1 . The median (IQR [range]) difference between effect-site concentration at loss of consciousness and recovery of consciousness was significantly lower in patients in the titration group at 1.2 (0.8-1.5 [0.1-2.9]) μg.ml-1 compared with the standard group 2.1 (1.9-2.6 [0.2-3.6] μg.ml-1 ; p < 0.0001). There was a positive correlation between effect-site concentration at loss of, and recovery of, consciousness (R = 0.41, p = 0.016) in the titration group, which was not seen in the standard group (R = -0.15, p = 0.44). In conclusion, using the modified Marsh pharmacokinetic model, the titration method for target-controlled infusion propofol at induction of anaesthesia allows closer matching of propofol concentration to depth of anaesthesia than the standard method.
Persistent Identifierhttp://hdl.handle.net/10722/258357
ISSN
2023 Impact Factor: 7.5
2023 SCImago Journal Rankings: 2.400
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMu, JJ-
dc.contributor.authorJiang, T-
dc.contributor.authorDeng, LP-
dc.contributor.authorChoi, SW-
dc.contributor.authorIrwin, MG-
dc.contributor.authorYuen, VMY-
dc.date.accessioned2018-08-22T01:37:11Z-
dc.date.available2018-08-22T01:37:11Z-
dc.date.issued2018-
dc.identifier.citationAnaesthesia, 2018, v. 73 n. 12, p. 1507-1514-
dc.identifier.issn0003-2409-
dc.identifier.urihttp://hdl.handle.net/10722/258357-
dc.description.abstractInduction of anaesthesia with target-controlled infusion of propofol may be achieved by stepwise increases in effect-site concentration until the patient loses consciousness (titration method), or by setting a high effect-site concentration target and observing the calculated effect-site concentration at loss of consciousness (standard method). When the estimated effect-site concentration at loss of consciousness is accurate, the difference between effect-site concentration at loss of consciousness and at recovery of consciousness should be small. This prospective, randomised, controlled trial was designed to compare this difference (effect-site concentration at loss of consciousness - effect-site concentration at recovery of consciousness) associated with the two techniques. Sixty-seven healthy patients undergoing elective hemithyroidectomy were recruited. Induction of anaesthesia was achieved using effect-site target-controlled infusion with the modified Marsh model and ke0 of 1.2 min-1 . The median (IQR [range]) difference between effect-site concentration at loss of consciousness and recovery of consciousness was significantly lower in patients in the titration group at 1.2 (0.8-1.5 [0.1-2.9]) μg.ml-1 compared with the standard group 2.1 (1.9-2.6 [0.2-3.6] μg.ml-1 ; p < 0.0001). There was a positive correlation between effect-site concentration at loss of, and recovery of, consciousness (R = 0.41, p = 0.016) in the titration group, which was not seen in the standard group (R = -0.15, p = 0.44). In conclusion, using the modified Marsh pharmacokinetic model, the titration method for target-controlled infusion propofol at induction of anaesthesia allows closer matching of propofol concentration to depth of anaesthesia than the standard method.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044-
dc.relation.ispartofAnaesthesia-
dc.subjectGeneral anaesthesia-
dc.subjectPropofol-
dc.subjectTarget-controlled infusion-
dc.subjectTitration-
dc.titleA comparison of two techniques for induction of anaesthesia with target-controlled infusion of propofol-
dc.typeArticle-
dc.identifier.emailChoi, SW: htswchoi@hku.hk-
dc.identifier.emailIrwin, MG: mgirwin@hku.hk-
dc.identifier.emailYuen, VMY: vtang131@hkucc.hku.hk-
dc.identifier.authorityChoi, SW=rp02552-
dc.identifier.authorityIrwin, MG=rp00390-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/anae.14355-
dc.identifier.pmid29956318-
dc.identifier.scopuseid_2-s2.0-85056182844-
dc.identifier.hkuros287526-
dc.identifier.volume73-
dc.identifier.issue12-
dc.identifier.spage1507-
dc.identifier.epage1514-
dc.identifier.isiWOS:000449669200009-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0003-2409-

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