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Präzision von „target-controlled infusion“ (TCI) mit zwei unterschiedlichen Propofolformulierungen

Accuracy of target-controlled infusion (TCI) with 2 different propofol formulations

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Zusammenfassung

Hintergrund

„Target controlled infusion“ (TCI) von Propofol war zunächst nur mit kodierten Fertigspritzen für das System Disoprifusor® möglich. Neuere TCI-Systeme erlauben den Einsatz beliebiger Propofolformulierungen. Wir haben die Präzision einer TCI sowie die Pharmakokinetik für zwei unterschiedliche Propofolformulierungen untersucht.

Material und Methoden

Zehn Probanden erhielten Disoprivan® 1% und Propofol 1% MCT Fresenius® als TCI unter Verwendung des Disoprifusor®-Modells. Der Vorhersagefehler der TCI wurde aus gemessenen arteriellen Konzentrationen bestimmt und die Pharmakokinetik mit einem Drei-Kompartiment-Modell analysiert.

Ergebnisse

Der mittlere Fehler und der mittlere absolute Fehler waren -1,4% und 23,3% für Disoprivan® 1% sowie -5,9% und 17,8% für Propofol 1% MCT Fresenius®. Die beiden Propofolformulierungen zeigten gleiche Pharmakokinetik mit einem kleineren Verteilungsvolumen als zur TCI-Steuerung verwendet.

Schlussfolgerungen

Das Disoprifusor®-Modell kann auch mit Propofol 1% MCT Fresenius® verwendet werden. Das große Verteilungsvolumen dieses Modells kann zu einem Überschießen der Konzentration führen.

Abstract

Background

Target-controlled infusion (TCI) of propofol was initially realized as a device for prefilled syringes (Diprifusor®). New TCI systems can be used with any propofol formulation. We compared two different propofol formulations with respect to accuracy of TCI and pharmacokinetics.

Materials and methods

A total of 10 volunteers received Diprivan® 1% and Propofol 1% MCT Fresenius® as TCI using the pharmacokinetic model of the Diprifusor®. The prediction error was determined from measured arterial concentrations. A three-compartment model was fitted to the concentration data.

Results

The median prediction error and the median absolute prediction error were -1.4% and 23.3% for Diprivan®, and -5.9% and 17.8% for Propofol Fresenius®. The drugs did not differ in pharmacokinetics but showed a smaller central volume of distribution than used for infusion control.

Conclusions

The pharmacokinetic model of Diprifusor® can also be used for TCI of Propofol Fresenius®. The large volume of distribution in this model may cause an overshoot in concentration.

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Diese Arbeit wurde gefördert durch Fresenius-Kabi GmbH, Deutschland.

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Friedrich-Alexander-Universität, Erlangen-Nürnberg

    H. Ihmsen, C. Jeleazcov, J. Schüttler, H. Schwilden & F. Bremer

  2. Klinik für Anästhesiologie, Friedrich-Alexander-Universität, Krankenhausstrasse 12, 91054 , Erlangen

    H. Ihmsen

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  1. H. Ihmsen
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  2. C. Jeleazcov
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  3. J. Schüttler
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  4. H. Schwilden
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  5. F. Bremer
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Correspondence to H. Ihmsen.

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Ihmsen, H., Jeleazcov, C., Schüttler, J. et al. Präzision von „target-controlled infusion“ (TCI) mit zwei unterschiedlichen Propofolformulierungen. Anaesthesist 53, 937–943 (2004). https://doi.org/10.1007/s00101-004-0753-6

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  • DOI: https://doi.org/10.1007/s00101-004-0753-6

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