British Journal of Anaesthesia, Vol 75, Issue 5 562-566, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
D. Russell, M. P. Wilkes, S. C. Hunter, J. B. Glen, P. Hutton and G. N. Kenny
We studied 160 ASA I-II patients, anaesthetized with propofol by infusion,
using either a manually controlled or target-controlled infusion system.
Patients were anaesthetized by eight consultant anaesthetists who had
little or no previous experience of the use of propofol by infusion. In
addition to propofol, patients received temazepam premedication, a single
dose of fentanyl and 67% nitrous oxide in oxygen. Each consultant
anaesthetized 10 patients in sequential fashion with each system. Use of
the target-controlled infusion resulted in more rapid induction of
anaesthesia and allowed earlier insertion of a laryngeal mask airway. There
was a tendency towards less movement in response to the initial surgical
stimulus and significantly less movement during the remainder of surgery.
Significantly more propofol was administered during both induction and
maintenance of anaesthesia with the target-controlled system. This was
associated with significantly increased end-tidal carbon dioxide
measurements during the middle period of maintenance only, but recovery
from anaesthesia was not significantly prolonged in the target- controlled
group. With the exception of a clinically insignificant difference in heart
rate, haemodynamic variables were similar in the two groups. Six of the
eight anaesthetists found the target-controlled system easier to use, and
seven would use the target-controlled system in preference to a manually
controlled infusion. Anaesthetists without prior experience of propofol
infusion anaesthesia quickly became familiar with both manual and
target-controlled techniques, and expressed a clear preference for the
target-controlled system.
CLINICAL INVESTIGATIONS
Manual compared with target-controlled infusion of propofol
University Department of Anaesthesia, Royal Infirmary, Glasgow G31 2ER; University Department of Anaesthesia, Queen Elizabeth Hospital, Birmingham B15 2TH; Clinical Research Group, Zeneca Pharamaceuticals, Macclesfield, Cheshire SK10 4TG; Glasgow University Department of Anaesthesia, HCI Hospital, Beardmore Street, Clydebank, Glasgow G81 4HX
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