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Abstract

The acronym TCI, standing for Target Controlled Infusion, refers to a system by which a drug is given intravenously with a pump controlled by a computer; a TCI system aims to get a target plasma concentration chosen by the user [1]. The importance of getting a steady plasma concentration of a drug lies in the link between that concentration and the concentration near the effector, in the assumption that the intensity of the pharmacological effect is proportional to the latter. Since the 1980s, TCI has been largely employed for controlling intravenous infusion of anaesthetics, analgesics, and sedatives since it is particularly suitable to quickly achieve and then maintain satisfactory degrees of anaesthesia, analgesia, and sedation. However, in last years, the use of this technique has been extended to many other drugs, such as antiarrhythmics, antineoplastics, and antibiotics [2–4], all sharing the common property that their pharmacokinetics can be described by a multicompartment model.

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References

  1. Gepts E (1998) Pharmacokinetic concepts for TCI anaesthesia. Anaesthesia 53 [Suppl 1]: 4–12

    Article  PubMed  CAS  Google Scholar 

  2. Woodnutt G, Berry V (1999) Two pharmacodynamic models for assessing the efficacy of amoxicillin-clavulanate against experimental respiratory tract infections caused by strains of Streptococcus pneumoniae. Antimicrob Agents Chemother 43: 29–34

    PubMed  CAS  Google Scholar 

  3. Bugnon D, Potel G, Xiong YQ et al (1997) Bactericidal effect of pefloxacin and fosfomycin against Pseudomonas aeruginosa in a rabbit endocarditis model with pharmacokinetics of pefloxacin in humans simulated in vivo. Eur J Clin Microbiol Infect Dis 16: 575–580

    Article  PubMed  CAS  Google Scholar 

  4. Wallace MS (1997) Concentration-effect relations for intravenous lidocaine infusions in human volunteers: effects on acute sensory thresholds and capsaicin-evoked hyperpathia. Anesthesiology 86: 1262–1272

    Article  PubMed  CAS  Google Scholar 

  5. Gepts E, Camu F, Cockshott ID, Douglas EJ (1987) Disposition of propofol administered as constant rate intravenous infusion in humans. Anesth Analg 66: 1256–1263

    Article  PubMed  CAS  Google Scholar 

  6. Tackley RM, Lewis GT, Prys-Roberts C et al (1987) Open loop control of propofol infusions. Br J Anaesth 59: 935

    Google Scholar 

  7. Cavaliere F, Pennisi MA, Meo F et al (1999) Target controlled infusion (TCI): applicazione del programma “Visual TCI” all’anestesia ed alla sedazione col Propofol. Min Anestesiol 65: 849–858

    CAS  Google Scholar 

  8. Maitre PO, Ausems ME, Vozeh H, Stansky DR (1988) Evaluating the accuracy of using population pharmacokinetic data to predict plasma concentration of alfentanil. Aesthesiology 68: 59–67

    Article  CAS  Google Scholar 

  9. Shafer SL, Siegel LC, Cooke JE, Scott JC (1988) Testing computer-controlled infusion pumps by simulation. Aesthesiology 68: 261–266

    Article  CAS  Google Scholar 

  10. Schuttler J, Kloos S, Schwilden H, Stoeckel H (1988) Total intravenous anaesthesia with propofol and alfentanil by computer-assisted infusion. Anaesthesia 43 [Suppl]: 2–7

    Article  PubMed  Google Scholar 

  11. Kirkpatrick T, Cockshott ID, Douglas EJ, Nimmo WS (1988) Pharmacokinetics of propofol (diprivan) in elderly patients. Br J Anaesth 60: 146–150

    Article  PubMed  CAS  Google Scholar 

  12. Chassard D, Berrada K, Bryssine B et al (1996) Influence of body compartments on propofol induction dose in female patients. Acta Anaesth Scand 40: 889–891

    Article  PubMed  CAS  Google Scholar 

  13. Wright PMC (1998) Population based pharmacokinetic analysis: why do we need it; what is it; and what has it told us about anaesthetics? Br J Anaesth 80: 488–501

    Article  PubMed  CAS  Google Scholar 

  14. Coetzee JF, Glen JB, Wium CA, Boshoff L (1995) Pharmacokinetic model selection for target controlled infusions of propofol. Anesthesiology 82: 1328–1345

    Article  PubMed  CAS  Google Scholar 

  15. Hans P, Coussaert E, Contraine F et al (1997) Predictive accuracy of continuous propofol infusions in neurosurgical patients: comparison of pharmacokinetic models. J Neurosurg Anes-thesiol 9: 112–117

    Article  CAS  Google Scholar 

  16. Glen JB (1998) The development of “Diprifusor”: a TCI system for propofol. Anaesthesia 53 [Suppl 1]: 13–21

    Article  PubMed  CAS  Google Scholar 

  17. Marsh B, White M, Morton N, Kenny GNC (1991) Pharmacokinetic model driven infusion of propofol in children. Br J Anaesth 67: 41–48

    Article  PubMed  CAS  Google Scholar 

  18. Servin F, Desmonts JM, Haberer JP et al (1988) Pharmacokinetics and protein binding of propofol in patients with cirrhosis. Anesthesiology 69: 887–891

    Article  PubMed  CAS  Google Scholar 

  19. Adam HK, Briggs LP, Bahar M et al (1983) Pharmacokinetic evaluation of ICI 35868 in man. Br J Anaesth 55: 97–103

    Article  PubMed  CAS  Google Scholar 

  20. Kay NH, Sear JW, Uppington J et al (1986) Disposition of propofol in patients undergoing surgery. Br J Anaesth 58: 1075–1079

    Article  PubMed  CAS  Google Scholar 

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© 2001 Springer-Verlag Italia

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Cavaliere, F., Pennisi, M.A., Proietti, R. (2001). Target-Controlled Infusion: Definition, Methods, and Limits. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2903-3_39

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  • DOI: https://doi.org/10.1007/978-88-470-2903-3_39

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0136-7

  • Online ISBN: 978-88-470-2903-3

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