Correction of target-controlled infusion following wrong selection of emulsion concentrations of propofol.
10.4097/kjae.2014.66.5.377
- Author:
Yun Jeong CHAE
1
;
Han Bum JOE
;
Won Il LEE
;
Jin A KIM
;
Sang Kee MIN
Author Information
1. Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. anesmin@nate.com
- Publication Type:Original Article
- Keywords:
Drug delivery systems;
Infusion pumps;
Intravenous infusion;
Propofol
- MeSH:
Drug Delivery Systems;
Infusion Pumps;
Infusions, Intravenous;
Plasma;
Propofol*
- From:Korean Journal of Anesthesiology
2014;66(5):377-382
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We investigated the correction methods following wrong-settings of emulsion concentrations of propofol as a countermeasure against erroneous target-controlled infusions (TCI). METHODS: TCIs were started with targeting 4.0 microg/ml of effect-site concentration (C(eff)) of propofol, and the emulsion concentrations were selected for 2.0% instead of 1.0% (FALSE(1-2), n = 24), or 1.0% instead of 2.0% (FALSE(2-1), n = 24). These wrong TCIs were corrected at 3 min after infusion start. During FALSE(1-2), the deficit was filled up while injecting after equilibrium (n = 12), or while overriding (n = 12). During FALSE(2-1), the overdose was evacuated while targeting C(eff) (n = 12) or targeting plasma concentration (C(p)) (n = 12). The gravimetrical measurements of TCI reproduced the C(p) and C(eff) using simulations. The reproduced C(eff) at 3 min (C(eff-3min)) and the time to be normalized within +/- 5% of target C(eff) (T(+/-5%)), were compared between the correction methods. RESULTS: During the wrong TCI, C(eff-3min) was 1.98 +/- 0.01 microg/ml in FALSE(1-2), and 7.99 +/- 0.05 microg/ml in FALSE(2-1). In FALSE(1-2), T(+/-5%) was significantly shorter when corrected while overriding (3.9 +/- 0.25 min), than corrected after equilibrium (6.9 +/- 0.05 min) (P < 0.001). In FALSE(2-1), T(+/-5%) was significantly shorter during targeting C(p) (3.6 +/- 0.04 min) than targeting C(eff) (6.7 +/- 0.15 min) (P < 0.001). CONCLUSIONS: The correction methods, based on the pharmacokinetic and pharmacodynamic characteristics, could effectively and rapidly normalize the wrong TCI following erroneously selections of the emulsion concentration of propofol.
