Effect compartment-controlled TCI can be safely applied in clinical practice. A biophase model combining the Marsh kinetics and a time to peak effect of 1.6 min accurately predicted the time course of propofol drug effect.
Overall, although injections induced analgesia at 1 month, these effects were reduced at 3- and 6-month follow-ups. No statistical differences were found between the three treatment groups (after 1 month, p = 0.71; after 3 months, p = 0.69; after 6 months, p = 0.66. The Friedman test showed a significant decrease in treatment score as a function of time in groups B and C (p = 0.015) but not in group A (p = 0.074). Corticosteroids seem responsible for the last phenomenon.
SummaryTen patients, undergoing elective orthopaedic surgery under spinal anaesthesia, were sedated with propofol using a closed-loop feedback control system. The bispectral index (BIS), a new processed EEG parameter, was used as control variable. Propofol administration was controlled by a patient individualised adaptive model-based controller incorporating target-controlled infusion technology combined with a pharmacokinetic-dynamic model. This feedback control system for propofol administration proved to be adequate and safe. BIS was found to be well suited as control variable.
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