Intravenous anesthesia


Anesthesia and Pain Medicine. 2002 Mar. 6(1): 19-23
ⓒ Korean Society for Intravenous Anesthesia
Mechanical Performance Errors of Commercial Target Controlled Infusion Devices
Ho-Yeong Kil, Hyun-Hwa Lee, Tae-Hyun Han, Hoon Park, Jung-Eun Lee, Jong-Hee Lee, Kook-Young Choi, Jae Mok Ahn
Department of Anesthesiology, School of Medicine, Hallym University, Seoul, Korea.,Department of Anesthesiology, School of Medicine, Chung-Nam National University, Seoul, Korea.,Division of Information and Communications Engineering, Hallym university, Seoul, Korea

BACKGROUND: The objectives of the present study were to assess the mechanical performance error of the three commercially available target controlled infusion devices incorporating the pharmacokinetic parameters proposed by Marsh et al. for the administration of propofol.
METHODS: After institutional review board approval and informed consent, forty-five ASA 1 or 2 adult patients undergoing elective orthopedic surgery were participated in this study. Atropine 0.5 mg was injected for premedication. Subjected TCI devices were \"A\", \"B\", \"C\" devices. Anesthesia was induced by a TCI of propofol with a target concentration of 6 microgram/ml and maintained around 3 5 microgram/ml according to the bispectral index (35 45). In the middle of surgery, target concentrations were increased to 6 microgram/ml and maintained until pseudo-steady state with the effect site concentration. Three minutes after equilibration, 3 ml of blood was drawn from the radial artery for measuring blood concentration using HPLC. Target concentrations were gradually decreased at the interval of 1 microgram/ml until the end of surgery and a blood sample was drawn as described in the above. A sample for every 1 microgram/ml was collected in the recovery room. Performance error of the predicted concentration of blood was calculated as measured-predicted concentration/predicted concentration 100.
RESULTS: \"A\" and \"C\" TCI showed acceptable performance error within 30%, however the degree of error was higher in \"B\". And \"B\" TCI showed more than acceptable performance error in low target concentration and showed transition of error at higher concentration (5 6 microgram/ml) compared to \"A\" and \"C\" TCI.
CONCLUSIONS: \"A\" and \"C\" TCI showed more acceptable mechanical performance error than \"B\" TCI device.
Key words : Equipment, target controlled infusion device, Statistics, performance error
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