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[Target-controlled infusion of propofol for intraoperative sedation: determination of effect-site concentration and assessment of bispectral index].
Ann Fr Anesth Reanim. 2004 Jul; 23(7):675-80.AF

Abstract

OBJECTIVES

To determine the effect-site concentration (Ce) of propofol, required to achieving adequate sedation. To assess the efficacy and safety of a target-controlled infusion system during monitored anaesthesia care and to evaluate the ability of bispectral index (BIS) to predict sedation level. Study design. - Prospective clinical study.

PATIENTS

Women scheduled for insertion of tension-free vaginal tape under local anaesthetic infiltration.

METHODS

After premedication with hydroxyzine, 1% propofol was infused using the Diprifusor system at an initial target plasma concentration (Cc) of 1 microg/ml and then adjusted by steps of 0.2 microg/ml at 5 min intervals. The level of sedation was assessed using the observer's assessment of alertness/sedation (OAA/S) scale; the objective was to obtain an OAA/S level at 4 or 3 (response to verbal stimulation). Ce of propofol and BIS were noted every 5 min. Relation between Ce or BIS and OAA/S scale was analysed by linear regression and probability of prediction (P(K)).

RESULTS

Fifty patients aged 62 +/- 12 years were studied. Sedation at level 4 or 3 was observed in all patients. Ce of propofol and BIS to maintain this OAA/S score were, respectively, 1.0 +/- 0.2 microg/ml and 87 +/- 7. There was a linear relation between OAA/S scale and BIS or Ce; however, individual values demonstrate wide variability. The average of P(K) values computed for each patient for the BIS and Ce was 0.84 and 0.83, respectively.

CONCLUSIONS

Target-controlled infusion of propofol provides easy and safe management of intraoperative sedation, allowing a fast and precise adjustment of the propofol concentration to the clinical response of the patient.

Authors+Show Affiliations

Département d'anesthésie-réanimation-I, CHU Pellegrin, 33076 Bordeaux cedex, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

15324954

Citation

Quinart, A, et al. "[Target-controlled Infusion of Propofol for Intraoperative Sedation: Determination of Effect-site Concentration and Assessment of Bispectral Index]." Annales Francaises D'anesthesie Et De Reanimation, vol. 23, no. 7, 2004, pp. 675-80.
Quinart A, Nouette-Gaulain K, Pfeiff R, et al. [Target-controlled infusion of propofol for intraoperative sedation: determination of effect-site concentration and assessment of bispectral index]. Ann Fr Anesth Reanim. 2004;23(7):675-80.
Quinart, A., Nouette-Gaulain, K., Pfeiff, R., Revel, P., & Sztark, F. (2004). [Target-controlled infusion of propofol for intraoperative sedation: determination of effect-site concentration and assessment of bispectral index]. Annales Francaises D'anesthesie Et De Reanimation, 23(7), 675-80.
Quinart A, et al. [Target-controlled Infusion of Propofol for Intraoperative Sedation: Determination of Effect-site Concentration and Assessment of Bispectral Index]. Ann Fr Anesth Reanim. 2004;23(7):675-80. PubMed PMID: 15324954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Target-controlled infusion of propofol for intraoperative sedation: determination of effect-site concentration and assessment of bispectral index]. AU - Quinart,A, AU - Nouette-Gaulain,K, AU - Pfeiff,R, AU - Revel,P, AU - Sztark,F, PY - 2003/08/06/received PY - 2004/04/15/accepted PY - 2004/8/25/pubmed PY - 2004/11/13/medline PY - 2004/8/25/entrez SP - 675 EP - 80 JF - Annales francaises d'anesthesie et de reanimation JO - Ann Fr Anesth Reanim VL - 23 IS - 7 N2 - OBJECTIVES: To determine the effect-site concentration (Ce) of propofol, required to achieving adequate sedation. To assess the efficacy and safety of a target-controlled infusion system during monitored anaesthesia care and to evaluate the ability of bispectral index (BIS) to predict sedation level. Study design. - Prospective clinical study. PATIENTS: Women scheduled for insertion of tension-free vaginal tape under local anaesthetic infiltration. METHODS: After premedication with hydroxyzine, 1% propofol was infused using the Diprifusor system at an initial target plasma concentration (Cc) of 1 microg/ml and then adjusted by steps of 0.2 microg/ml at 5 min intervals. The level of sedation was assessed using the observer's assessment of alertness/sedation (OAA/S) scale; the objective was to obtain an OAA/S level at 4 or 3 (response to verbal stimulation). Ce of propofol and BIS were noted every 5 min. Relation between Ce or BIS and OAA/S scale was analysed by linear regression and probability of prediction (P(K)). RESULTS: Fifty patients aged 62 +/- 12 years were studied. Sedation at level 4 or 3 was observed in all patients. Ce of propofol and BIS to maintain this OAA/S score were, respectively, 1.0 +/- 0.2 microg/ml and 87 +/- 7. There was a linear relation between OAA/S scale and BIS or Ce; however, individual values demonstrate wide variability. The average of P(K) values computed for each patient for the BIS and Ce was 0.84 and 0.83, respectively. CONCLUSIONS: Target-controlled infusion of propofol provides easy and safe management of intraoperative sedation, allowing a fast and precise adjustment of the propofol concentration to the clinical response of the patient. SN - 0750-7658 UR - https://www.unboundmedicine.com/medline/citation/15324954/[Target_controlled_infusion_of_propofol_for_intraoperative_sedation:_determination_of_effect_site_concentration_and_assessment_of_bispectral_index]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0750765804002187 DB - PRIME DP - Unbound Medicine ER -