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TCI in Special Patients Groups: The Elderly and Obese

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Total Intravenous Anesthesia and Target Controlled Infusions

Abstract

A generally recognized benefit of target-controlled infusion (TCI) systems is that they provide the anesthetist with a convenient and precise way to titrate intravenous drugs (currently propofol, remifentanil, and sufentanil in commercially available devices) according to the patient’s needs. This is of course particularly important in special patient groups when the usual dosing schemes may not apply. However, the use of a TCI system does not modify the drug’s intrinsic pharmacology, and the accuracy of the system depends widely on how well the pharmacokinetic (PK) model implemented in the device matches the characteristics of the patient receiving the infusion. This chapter will describe the way that TCI may be used in specific, special populations such as the elderly or obese patients: populations frequently presenting for surgery and in whom precautions should be taken when applying pharmacokinetic models since their characteristics may be outside of the ranges of the covariates of the population in whom the model(s) were developed.

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Authors and Affiliations

  1. APHP HUPNVS Hôpital Bichat, Anesthesia and Intensive Care, 46, rue Henri Huchard, Paris, 75018, France

    Frederique S. Servin MD, PhD

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  1. Frederique S. Servin MD, PhD
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Correspondence to Frederique S. Servin MD, PhD .

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Editors and Affiliations

  1. Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Anthony R. Absalom

  2. Department of Anesthesia, Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA

    Keira P. Mason

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Servin, F.S. (2017). TCI in Special Patients Groups: The Elderly and Obese. In: Absalom, A., Mason, K. (eds) Total Intravenous Anesthesia and Target Controlled Infusions. Springer, Cham. https://doi.org/10.1007/978-3-319-47609-4_29

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  • DOI: https://doi.org/10.1007/978-3-319-47609-4_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-47607-0

  • Online ISBN: 978-3-319-47609-4

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