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BJA Advance Access published online on January 28, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei081
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted November 18, 2004

Laboratory Investigation

Precision and bias of target controlled propofol infusion for sedation{dagger}

M. A. Frölich 1*, D. M. Dennis 1, J. A. Shuster 1, and R. J. Melker 1

1 Department of Anesthesiology, University of Florida Colleges of Medicine and Engineering, Gainesville, Florida, USA; Department of Statistics, University of Florida Colleges of Medicine and Engineering, Gainesville, Florida, USA; Department of Pediatrics, University of Florida Colleges of Medicine and Engineering, Gainesville, Florida, USA; Department of Biomedical Engineering, University of Florida Colleges of Medicine and Engineering, Gainesville, Florida, USA

* To whom correspondence should be addressed.
M. A. Frölich, E-mail: froelich{at}uab.edu


  Abstract

Background. The purpose of this study is to test precision and systematic bias of a target controlled infusion (TCI) of propofol in human volunteers at two sedative concentrations.

Methods. We studied the ‘Diprifusor’ model (Marsh Pharmacokinetics and a Graseby® 3400 infusion pump) in 18 human volunteers at two sedative target plasma concentrations (0.5 and 1.0 µg ml-1). Twenty minutes after infusion start or change and 20 min after discontinuation of the infusion plasma propofol concentrations were measured using liquid chromatography-mass spectroscopy (LC-MS). Plasma propofol concentrations were compared with concentrations predicted by the TCI system. Agreement of those two measures (precision and bias) was determined using regression analysis.

Results. We found little systematic bias but poor precision. When setting the TCI system to deliver a plasma concentration of 1.0 µg ml-1 one can predict the actual plasma concentration with 95% confidence only within a range of 0.44-1.38 µg ml-1.

Conclusions. This finding helps to explain differences in responses to propofol sedation; pharmacokinetic variability appears to be an important factor.

Keywords: anaesthetics, i.v., propofol; anaesthetic techniques, computer-assisted continuous infusion; equipment, infusion pump; model, computer; pharmacokinetics, model; statistics, regression analysis.
{dagger} Presented in abstract format at the World Congress of Anaesthesiology, Paris, 2004.
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