CLC number: R4
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Received: 2004-04-22
Revision Accepted: 2004-07-07
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LI Yu-hong, XU Jian-hong, YANG Jian-jun, TIAN Jie, XU Jian-guo. Predictive performance of ‘Diprifusor’ TCI system in patients during upper abdominal surgery under propofol/fentanyl anesthesia[J]. Journal of Zhejiang University Science B, 2005, 6(1): 43-48.
@article{title="Predictive performance of ‘Diprifusor’ TCI system in patients during upper abdominal surgery under propofol/fentanyl anesthesia",
author="LI Yu-hong, XU Jian-hong, YANG Jian-jun, TIAN Jie, XU Jian-guo",
journal="Journal of Zhejiang University Science B",
volume="6",
number="1",
pages="43-48",
year="2005",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2005.B0043"
}
%0 Journal Article
%T Predictive performance of ‘Diprifusor’ TCI system in patients during upper abdominal surgery under propofol/fentanyl anesthesia
%A LI Yu-hong
%A XU Jian-hong
%A YANG Jian-jun
%A TIAN Jie
%A XU Jian-guo
%J Journal of Zhejiang University SCIENCE B
%V 6
%N 1
%P 43-48
%@ 1673-1581
%D 2005
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2005.B0043
TY - JOUR
T1 - Predictive performance of ‘Diprifusor’ TCI system in patients during upper abdominal surgery under propofol/fentanyl anesthesia
A1 - LI Yu-hong
A1 - XU Jian-hong
A1 - YANG Jian-jun
A1 - TIAN Jie
A1 - XU Jian-guo
J0 - Journal of Zhejiang University Science B
VL - 6
IS - 1
SP - 43
EP - 48
%@ 1673-1581
Y1 - 2005
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2005.B0043
Abstract: Objective: To evaluate the predictive performance of ‘diprifusor’ TCI (target-controlled infusion) system for its better application in clinical anesthesia. Methods: The predictive performance of a ‘diprifusor’ TCI system was investigated in 27 Chinese patients (16 males and 11 females) during upper abdominal surgery under total intravenous anesthesia (TIVA) with propofol/fentanyl. Measured arterial propofol concentrations were compared with the values predicted by the TCI infusion system. Performance was determined by the median performance error (MDPE), the median absolute performance error (MDAPE), the divergence (the percentage change of the absolute PE with time), and the wobble (the median absolute deviation of each PE from the MDPE). Results: The median (range) values of 14.9% (-21.6%~42.9%) for MDPE, 23.3% (6.9%~62.5%) for MDAPE, -1.9% h-1 (-32.7%~23.0% h-1) for divergence, and 18.9% (4.2%~59.6%) for wobble were obtained from 227 samples from all patients. For the studied population, the PE did not increase with time but with increasing target propofol concentration, particularly following induction. Conclusions: The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgical operation and the predictive performance of the ‘diprifusor’ target controlled infusion system was considered acceptable for clinical purposes. But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires improvement.
[1] Absalom, A.R., Kenny, G.N., 2003. Closed-loop control of propofol anaesthesia using bispectral index: performance assessment in patients receiving computer-controlled propofol and manually controlled remifentanyl infusions for minor surgery. Br J Anaesth, 90(6):737-741.
[2] Davison, J.A., Macleod, A.D., Howie, J.C., 1993. Effective concentration 50 for propofol with and without 67% nitrous oxide. Acta Anesthesiologica Scandinavia, 37:458-464.
[3] Dwyer, R.C., Fee, J.P., Howard, P.J., 1991. Arterial washing of halothane and isoflurane in young and elderly adult patients. Br J Anesth, 66:572-579.
[4] Frei, F.J., Zbinden, A.M., Thomson, D.A., 1991. Is the end-tidal partial pressure of isoflurane a good predictive of arterial partial pressure? Br J Anesth, 66:331-339.
[5] Gepts, E., Camu, F., Cockshott, I.D., 1987. Disposition of propofol administered as constant rate intravenous infusions in humans. Anaesth and Analg, 66:1256-1263.
[6] Glass, P.J., Jacobs, J.R., Reeves, J.G., 1990. Intravenous Drug Delivery. In: Milder, R.D. (Ed.), Anesthesia, 3rd Ed. Churchill Livingstone, New York, p.367-388.
[7] Glen, J.B., 1998. Development of ‘Diprifusor’: a TCI system for propofol. Anesthesia, 53(suppl 1):13-21.
[8] Li, Y.H., Rui, J.Z., 2003. Population pharmacokinetics of propofol in Chinese patients. Acta Pharmacol Sin, 24(6):581-588.
[9] Marsh, B., White, M., Morton, M., 1991. Pharmacokinetic model driven infusion of propofol in children. Br J Anesth, 67:41-48.
[10] Mertens, M.J., Engbers, F.H., Burm, A.G., Vuyk, J., 2003. Predictive performance of computer-controlled infusion of remifentanyl during propofol/remifentanyl anaesthesia. Br J Anaesth, 90(2):132-141.
[11] Plummer, G.F., 1987. Improved method for the determination of propofol in blood by high-performance liquid chromatography with fluorescence detection. J Chromatogr, 421:171-176.
[12] Schuttler, J., Ihmsen, H., 2000. Population pharmacokinetics of propofol. Anesthesiology, 92:727-738.
[13] Swinhoe, C.F., Peacock, J.E., Glen, J.B., 1998. Evaluation of the predictive performance of a ‘Diprifusor’ TCI system. Anesthesia, 53(Supp 1):61-67.
[14] Varvel, J.R., Donoho, D.L., Shafer, S.L, 1992. Measuring the predictive performance of computer-controlled infusion pumps. J Pharmacokin Biopharm, 20:63-94.
Open peer comments: Debate/Discuss/Question/Opinion
<1>
taira@china <caoyangtaira@163.com>
2010-05-18 14:45:53
it is very good