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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTHESIOLOGY
Minerva Anestesiologica 1999 October;65(10):701-9
Manual infusion of propofol compared with Diprifusor TCI: acceptability, efficacy and safety
Mazzarella B. 1, Melloni C. 2, Montanini S. 3, Novelli G. P. 4, Peduto V. A. 5, Santandrea E. 6, Vincenti E. 7, Zattoni J. 8
1 Università degli Studi - Napoli, Azienda Policlinico Federico II, Istituto di Anestesia e Rianimazione;
2 Presidio Ospedaliero di Lugo - Lugo (Ravenna), Servizio di Anestesia e Rianimazione;
3 Università degli Studi - Messina, Azienda Policlinico Universitario, Istituto di Anestesia e Rianimazione;
4 Università degli Studi - Firenze, Azienda Ospedaliera Careggi, Istituto di Anestesiologia e Rianimazione;
5 Università degli Studi - Perugia, Policlinico Monteluce, Istituto di Anestesiologia e Rianimazione;
6 Azienda Ospedaliera Ospedale Niguarda Ca’ Granda - Milano, II Servizio di Anestesia e Rianimazione;
7 Istituto per l’Infanzia Burlo Garofalo - Trieste, Servizio di Anestesia e Rianimazione;
8 Università degli Studi - Genova, Azienda Ospedaliera Ospedale S. Martino, Istituto di Anestesiologia e Rianimazione
Background. Diprifusor TCI is a newly developed target-controlled system for the infusion of propofol. Purpose of this study is to evaluate the acceptability, efficacy and safety of Diprifusor TCI in comparison with the manually controlled technique.
Methods. This multicentre, randomised, parallel group study was carried out in 160 patients undergoing surgical procedures of 10 min to 4 h duration in 8 centres. In each centre 20 male or female patients, aged ≥18 years, ASA I-III were randomised to treatment with either Diprifusor TCI (TCI group—80 patients) or manually controlled infusion (MI group—80 patients). Assessments included hemodynamics; adverse events, including accidents, actual or possible; recovery times; anesthetist ratings of quality of induction and maintenance, and of ease of control and use of technique. Ratings were summed up in a global quality score (study end-point).
Results. Induction doses were significantly lower (median values 1.4 vs 1.9 mg/kg) and maintenance infusion rate significantly higher (median values 10.2 vs 8.8 mg/kg/h) in the TCI group; anesthetists ratings obtained maximum scores in most patients of either group, but more frequently in the TCI group, with significant differences for ease of control (good 91.2% TCI vs 74.7% IM; adequate 8.8 vs 21.5%; poor 0 vs 3.8%), and of use of technique (good 91.2% TCI vs 60.8% IM; adequate 8.8 vs 39.2%); the global quality score showed a significant advantage for the TCI system (median value 12 vs 11).
Conclusions. The TCI technique is effective and safe, and has a better acceptability than the manually controlled infusion technique.