Intravenous anesthesia


Anesthesia and Pain Medicine. 2002 Dec. 6(4): 187-193
ⓒ Korean Society for Intravenous Anesthesia
Evaluation of Anesthesia According to Pharmacokinetic Model of Target Controlled Infusion for Propofol Using Stelpump
Taekmin Kwon, M.D., Jun Heum Yon, M.D., Woo Yong Lee, M.D., Younsuk Lee, M.D.
Department of Anesthesiology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea

BACKGROUND: Target concentration infusion (TCI) for propofol by computer simulation has been used according to several pharmacokinetic models. The aims of this study was to evaluate the effect of these pharmacokinetic models on the induction, maintenance, and emergence of anesthesia.
METHODS: Forty two ASA 1 or 2 adult patients undergoing appendectomy participated in the study. Patients was divided into 4 groups, Shafer, Marsh, Tackley, Coetzee model, according to pharmacokinetic model of TCI for propofol using stelpump. Anesthesia was induced by TCI for propofol with a target concentration of 4.50 microgram/ml in all groups. TCI was started, and then we measured that total infused volumes and effect site concentration of propofol and duration taken to loss of response to verbal stimuli. Anesthesia was maintained by a TCI for propofol and 67% N2O and 33% O2. After TCI for propofol and administration of N2O were discontinued, it was measured that predicted plasma and effect site concentration of propofol and recovery time represented as verbal response.
RESULTS: Effect site concentration of propofol and induction time in the Shafer model were lower and faster than the Coetzee model (P < 0.05). Predicted plasma and effect site concentration of propofol at verbal response during recovery in the Tackley model were higher than the other models (P < 0.05).
CONCLUSIONS: Shafer model is useful for fast induction of anesthesia by a TCI for propofol using Stelpump in target concentration of 4.50 microgram/ml.
Key words : Pharmacokinetic models, propofol, target controlled infusion
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