An analytical study of standard propofol- sufentanil target controlled infusion protocols for total intravenous anaesthesia requirements in an Indian population using bispectral index monitoring

Maruti Gupta; Nitesh Agrawal

doi:10.18203/2320-6012.ijrms20171258

Authors

Maruti Gupta Department of Anesthesiology and Critical Care, Command Hospital, Lucknow, Uttar Pradesh, India
Nitesh Agrawal Department of Anesthesiology and Critical Care, Command Hospital, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20171258

Keywords:

BIS monitoring, TCI, TIVA

Abstract

Background: Target controlled infusion (TCI) is an automated and regulated total intravenous anaesthesia delivering device. On the basis of western pharmacokinetic and pharmacodynamic models it delivers a calculated dosage of intravenous anaesthetic drugs to achieve an ideal anaesthetic plane. The depth of anaesthesia is judged by monitors such as bispectral index (BIS) monitors which gives a rough estimate whether the TCI is delivering more or less.

Methods: This analytical study was carried out on 100 patients between 20 to 60 years of age in a teaching hospital. Simultaneous BIS monitoring and TCI were set on these patients. If BIS values went below 45 the target concentration was decreased by 0.5μg/ml and if it was more than Injection propofol was supplemented manually and the changes were collected and analyzed.

Results: On analyses and comparison of the data with a western study it was found that the duration of surgery was similar in both studies. With the help of “t” test based on normal distribution it was found that group having BIS <45 and 45-60 were similar in both studies, but the group having BIS >60 was more statistically significant in the Indian population.

Conclusions: Depth of anaesthesia was assessed with neurological monitor, BIS, at the time of administration of Target controlled infusion (TCI) and data acquired was compared with data from a western study. The two groups had similar anaesthetic depth levels with the same infusion protocols of Target controlled infusion (TCI).

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Author Biography

Maruti Gupta, Department of Anesthesiology and Critical Care, Command Hospital, Lucknow, Uttar Pradesh, India

Deptt of Anaethesiology and critical care

References

Pederson T, Johansen SH. Serious morbidity attributable to anaesthesia: considerations for prevention. Anaesthesia. 1989;44:504-8.

Breslin DS, Mirakhur RK, Reid JE, Kyle A. Manual versus target controlled infusions of propofol. Anaesthesia. 2004;59(11):1059-63.

Glass PSA, Rampil IJ. Automated anaesthesia: Fact or Fantasy? Anaesthesiology. 2001;95:1-2.

Ohara DA, Bogen DK, Noordergraaf A. The use of computers for controlling the delivery of anaesthesia. Anaesthesiology. 1992;77:561-83.

Marsh B, White M, Morton N. Pharmacokinetic model driven infusion of propofol in children. British J Anaesthesia. 1991;67:41-8.

Schuttler JH, Schwilden H. Stoeckel. Pharmacokinetics as applied to total intravenous anaesthesia. Anaesthesia. 1983;38:53-6.

Evans JM Jr, Davies WL. Monitoring anaesthesia. Clinics in anaesthesiology.1984;2:243.

AS Fiset, Pierre. Practical pharmacokinetics as applied to our daily anaesthesia practise. Canadian J Anaesthesia. 2001;46:48-55.

Zhong T, Guo QL, Pang D. Comparative evaluation of the cerebral state index and the bispectral index during target controlled infusion of propofol. Br J Anaesth. 2007;75:48-56.

Johansen JW, Sebel PS. Development and clinical application of EEG bispectrum monitoring. Anaesthesiology. 2000;93:1336-44.

Lyakowski L, Dumont, Pelligrini M. Effects of fentanyl, remifentanil, alfentanil and sufentanil on loss of consciousness and bispectral index during propofol induction of anaesthesia. Br J Anaesth. 2001;86:763-8.

Perreault L, Vezina D, Roberts K. Low dose Sufentanil in major surgery. Canadian J Anaesthesia. 1990;37(6):629-35.

Mathews DM, Rahman SS, Cirullo PM and Mallik RJ. Increases in Bispectral index lead to interventions that prevent possible intraoperative awareness. Br J Anaesth. 1995;92(2):193-6.

Morris L. A new vaporizer for liquid anaesthetic agents. Anesthesiology. 1952;13:587.

White PF. Use of patient-controlled analgesia for management of acute pain. JAMA. 1988;259:243-7.

Goerig M. The avertin story. In: Fink B, Morris LE, Stephen CR, (eds): The History of Anesthesia. Third International Symposium. Park Ridge, IL, Wood Library-Museum of Anesthesiology, 1992.

Lundy J. Intravenous anesthesia: Preliminary report of the use of two new thiobarbiturates. Proc Mayo Clin. 1935;10:536-43.

Bennetts FE. Thiopentone anaesthesia at Pearl Harbor. Br J Anaesth. 1995;75:366-8.

Kay B, Rolly G. I.C.I. 35868, a new intravenous induction agent. Acta Anaesthesiol Belg. 1977;28:303-16.

Schwilden H, Stoeckel H , Schuttler J. closed loop feedback control of propofol anaesthesia by quantitative EEG analysis in humans. Br J Anaesth. 1989;62:290-6.

Tempe DK, Satyanarayanan L. Is there any alternative to the bispectral index monitor? Br J Anaesth. 2004;92(1):1-3.