Klinisch effect van propofol Target-controlled –infusion.

Dubero, K.V. (2015) Klinisch effect van propofol Target-controlled –infusion. thesis, Medicine.

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Abstract

Background: Target controlled infusion (TCI) systems are programmed with pharmacokinetic/pharmacodynamics models which can be used to titrate propofol towards a predicted plasma concentration. These PK/PD models are population based and therefore not accurately enough for individuals because of inter-individual differences. Objective: This study was conducted to see whether adaptation of a population based model of propofol could decrease the residual error between predicted and measured plasma concentration. In this substudy we look if this will be relevant for the clinical outcomes such as Bispectral Index (BIS), Heart rate (HR) and Mean Arterial Pressure (MAP). We expect that there will be no differences in clinical effects between control and interventiongroup. Methods: 82 patients undergoing off-pump coronary artery bypass graft surgery (CABG) and receiving titrated propofol via TCI were randomized into an intervention group and a control group. In the intervention group, propofol concentrations in blood samples obtained prior to 60 minutes after start of propofol infusion were measured with the ‘Pelorus 500 analyser’. The concentrations were entered in the TCI system as input for the adaptation. On t= 55 and 165 min samples were taken to evaluate de sample adaptation. In the control group, blood samples were taken at concurrent sample times and propofol concentrations were measured likewise. However there was no adaptation of the PK model. CAROLA has been synchronized to our TCI system so we would evaluate the clinical effects by adaptation. Results: There were no significant difference between the two groups for BIS p=0.220, HR p= 0.883 and MAP p=0.629 change between t= 55 min en 65 min. There were also no significant difference between t=55 and t= 120 min. BIS p=0.267, HR p=0.993 MAP p=0.285 Conclusion: Clinical effects around the adaptation were evaluated. There were no significant change in BIS, MAP and HR. Continuation of this study is necessary to include required sample of 120 patients.

Item Type:	Thesis (Thesis)
Supervisor name:	Berg, J.P. van den M.D. and Struys, Prof. M.M.R.F. M.D. Ph.D.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/982

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