A comparative study of target controlled infusion (TCI) and manual controlled infusion (MCI) of propofol for sedation during cerebral protection in severe traumatic brain injured patient
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Date
2010
Authors
Hassan, Wan Mohd Nazaruddin Wan
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajians Sains Perubatan, Universiti Sains Malaysia
Abstract
Background. The aims of this study are to compare TCI with MCI propofol as sedation
in severe traumatic brain-injured (TBI) patients.
Methods. Post emergency craniotomy for severe mi patients (n = 50), were randomly
assigned to receive propofol sedation over 24 hours using two modes of infusion: TCI
versus MCI (n = 25 in each groups). Sedation was monitored using bispectral index SSIS)
monitor and sedation agitation scale (SAS). TCI was titrated between 0.2-2.0 J.l.g mr and
MCI was between 0.3-4.0 mg kg-1 h-1 to achieve sedative state at BIS 60-70 and SAS 2-3.
Mean arterial pressure (MAP), heart rate (HR), intracranial pressure (ICP), cerebral
perfusion pressure (CPP), time taken and volume used to achieve BIS 70, total volume of
propofol over 24 hours and recovery time to BIS 90 were recorded.
Results. TCI achieved BIS 70 significantly faster than MCI (6.3 ± 2.9 min vs. 19.7 ± 7.0
min). Total volume of propofol at BIS 70 was significantly less in TCI (12.0 ± 2.9 ml
vs.17.8 ± 4.3 ml). Recovery time to BIS 90 was also significantly faster in TCI (24.4 ±
11.5 min vs. 57.3 ± 19.9 min). TCI showed significantly lower in HR and ICP trends over
24 hours. CPP trends were significantly higher in TCI. There were no significant
differences in MAP and total volume over 24 hours.
Conclusions. TCI modes had more advantages for propofol sedation in TBI by providing
faster onset and offset of sedation and better in controlling ICP and CPP.
Description
Keywords
anaesthetic