Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study
Summary Background: This study was designed to evaluate the feasibility of propofol infusion by a closed-loop system for the titration of anaesthetic induction guided by Bispectral Index. Methods: Forty patients were prospectively and randomly allocated into two groups: the target control infusion (...
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| Veröffentlicht in: | European journal of anaesthesiology 2006-06, Vol.23 (6), p.465-469 |
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| container_title | European journal of anaesthesiology |
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| creator | Liu, N. Chazot, T. Trillat, B. Pirracchio, R. Law-Koune, J.-D. Barvais, L. Fischler, M. |
| description | Summary Background: This study was designed to evaluate the feasibility of propofol infusion by a closed-loop system for the titration of anaesthetic induction guided by Bispectral Index. Methods: Forty patients were prospectively and randomly allocated into two groups: the target control infusion (TCI) group, where propofol titration was performed manually guided by the Bispectral Index using a commercial pharmacokinetic model (Diprifusor device) and the closed-loop group where titration was performed using a proportional differential algorithm. For both groups, the objective was to achieve a Bispectral Index of 50. Remifentanil TCI was infused at a target of 2 ng mL−1 and was maintained constant throughout the study. Feasibility of automatic induction was evaluated with performance error and haemodynamic data. Results: Bispectral Index overshoot (−9 ± 13% vs. −16 ± 20%, P = 0.035) and mean duration of induction (381 ± 106 s vs. 490 ± 131 s, P = 0.004) were lower in the closed-loop group than in the TCI group. Haemodynamic data were similar between groups with a similar use of ephedrine bolus. Conclusion: The system was able to allow induction clinically for all patients. Automated titration guided by Bispectral Index for propofol infusion was feasible without increase in haemodynamic adverse effects. |
| doi_str_mv | 10.1017/S0265021506000196 |
| format | Article |
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Methods: Forty patients were prospectively and randomly allocated into two groups: the target control infusion (TCI) group, where propofol titration was performed manually guided by the Bispectral Index using a commercial pharmacokinetic model (Diprifusor device) and the closed-loop group where titration was performed using a proportional differential algorithm. For both groups, the objective was to achieve a Bispectral Index of 50. Remifentanil TCI was infused at a target of 2 ng mL−1 and was maintained constant throughout the study. Feasibility of automatic induction was evaluated with performance error and haemodynamic data. Results: Bispectral Index overshoot (−9 ± 13% vs. −16 ± 20%, P = 0.035) and mean duration of induction (381 ± 106 s vs. 490 ± 131 s, P = 0.004) were lower in the closed-loop group than in the TCI group. Haemodynamic data were similar between groups with a similar use of ephedrine bolus. Conclusion: The system was able to allow induction clinically for all patients. Automated titration guided by Bispectral Index for propofol infusion was feasible without increase in haemodynamic adverse effects.</description><identifier>ISSN: 0265-0215</identifier><identifier>EISSN: 1365-2346</identifier><identifier>DOI: 10.1017/S0265021506000196</identifier><identifier>PMID: 16672092</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Algorithms ; Anesthesia ; Anesthesia, General - methods ; Anesthetics, Intravenous - administration & dosage ; Beta blockers ; Blood Pressure - drug effects ; Clinical medicine ; Drug Delivery Systems - methods ; Drug Delivery Systems - statistics & numerical data ; Drug therapy ; Electroencephalography - drug effects ; Electroencephalography - methods ; Electroencephalography - statistics & numerical data ; Feasibility Studies ; Female ; Heart Rate - drug effects ; Humans ; Infusions, Intravenous - methods ; International standards ; Male ; Middle Aged ; Neurological disorders ; Original Article ; Plasma ; Propofol - administration & dosage ; Prospective Studies ; Software ; Thoracic surgery ; Ventilation</subject><ispartof>European journal of anaesthesiology, 2006-06, Vol.23 (6), p.465-469</ispartof><rights>2006 European Society of Anaesthesiology</rights><rights>Copyright Cambridge University Press Jun 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3674-7f10abdb02dc830418f24b518cb05ee7b5cd7698a03e787b7b2cb2f146feaffc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16672092$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, N.</creatorcontrib><creatorcontrib>Chazot, T.</creatorcontrib><creatorcontrib>Trillat, B.</creatorcontrib><creatorcontrib>Pirracchio, R.</creatorcontrib><creatorcontrib>Law-Koune, J.-D.</creatorcontrib><creatorcontrib>Barvais, L.</creatorcontrib><creatorcontrib>Fischler, M.</creatorcontrib><title>Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study</title><title>European journal of anaesthesiology</title><addtitle>Eur J Anaesthesiol</addtitle><description>Summary Background: This study was designed to evaluate the feasibility of propofol infusion by a closed-loop system for the titration of anaesthetic induction guided by Bispectral Index. Methods: Forty patients were prospectively and randomly allocated into two groups: the target control infusion (TCI) group, where propofol titration was performed manually guided by the Bispectral Index using a commercial pharmacokinetic model (Diprifusor device) and the closed-loop group where titration was performed using a proportional differential algorithm. For both groups, the objective was to achieve a Bispectral Index of 50. Remifentanil TCI was infused at a target of 2 ng mL−1 and was maintained constant throughout the study. Feasibility of automatic induction was evaluated with performance error and haemodynamic data. Results: Bispectral Index overshoot (−9 ± 13% vs. −16 ± 20%, P = 0.035) and mean duration of induction (381 ± 106 s vs. 490 ± 131 s, P = 0.004) were lower in the closed-loop group than in the TCI group. Haemodynamic data were similar between groups with a similar use of ephedrine bolus. Conclusion: The system was able to allow induction clinically for all patients. Automated titration guided by Bispectral Index for propofol infusion was feasible without increase in haemodynamic adverse effects.</description><subject>Algorithms</subject><subject>Anesthesia</subject><subject>Anesthesia, General - methods</subject><subject>Anesthetics, Intravenous - administration & dosage</subject><subject>Beta blockers</subject><subject>Blood Pressure - drug effects</subject><subject>Clinical medicine</subject><subject>Drug Delivery Systems - methods</subject><subject>Drug Delivery Systems - statistics & numerical data</subject><subject>Drug therapy</subject><subject>Electroencephalography - drug effects</subject><subject>Electroencephalography - methods</subject><subject>Electroencephalography - statistics & numerical data</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Infusions, Intravenous - methods</subject><subject>International standards</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurological disorders</subject><subject>Original Article</subject><subject>Plasma</subject><subject>Propofol - administration & dosage</subject><subject>Prospective Studies</subject><subject>Software</subject><subject>Thoracic surgery</subject><subject>Ventilation</subject><issn>0265-0215</issn><issn>1365-2346</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EokPhAdggqwt2AV8SO2EHIwqVKrEA1pEvxzMuThzshDK8BW-Mw4xUiYqVpXO-_9NvHYSeU_KKEipffyZMNITRhghCCO3EA7ShXDQV47V4iDbrulr3Z-hJzjeFaUruMTqjQkhGOrZBvy9BZa998PMBR4dNiBlsFWKc8OznpGYfx3UxpThFFwPeLd6CxfqA5z3gdz5PYAoX8NVo4Sd2MeEdjLBO1KggFyp7hf1oF7PK3mC1yv7G_A_ASY02Dv5XceZ5sYen6JFTIcOz03uOvl6-_7L9WF1_-nC1fXtdGS5kXUlHidJWE2ZNy0lNW8dq3dDWaNIASN0YK0XXKsJBtlJLzYxmjtbCgXLO8HP08ugtZb4vpWc_-GwgBDVCXHIvZMcZFbSAF_-AN3FJY-nWl33TdYK1BaJHyJSv5QSun5IfVDr0lPTrsfp7xyqZFyfxogewd4nTdQpQH4HbGGZI-VtYbiH1e1Bh3vfFQrioecVIUa7Sah3VJcZPXdSgk7c7uGv8_zZ_APuCsOc</recordid><startdate>200606</startdate><enddate>200606</enddate><creator>Liu, N.</creator><creator>Chazot, T.</creator><creator>Trillat, B.</creator><creator>Pirracchio, R.</creator><creator>Law-Koune, J.-D.</creator><creator>Barvais, L.</creator><creator>Fischler, M.</creator><general>Cambridge University Press</general><general>European Society of Anaesthesiology</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200606</creationdate><title>Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study</title><author>Liu, N. ; Chazot, T. ; Trillat, B. ; Pirracchio, R. ; Law-Koune, J.-D. ; Barvais, L. ; Fischler, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3674-7f10abdb02dc830418f24b518cb05ee7b5cd7698a03e787b7b2cb2f146feaffc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Algorithms</topic><topic>Anesthesia</topic><topic>Anesthesia, General - methods</topic><topic>Anesthetics, Intravenous - administration & dosage</topic><topic>Beta blockers</topic><topic>Blood Pressure - drug effects</topic><topic>Clinical medicine</topic><topic>Drug Delivery Systems - methods</topic><topic>Drug Delivery Systems - statistics & numerical data</topic><topic>Drug therapy</topic><topic>Electroencephalography - drug effects</topic><topic>Electroencephalography - methods</topic><topic>Electroencephalography - statistics & numerical data</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Infusions, Intravenous - methods</topic><topic>International standards</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurological disorders</topic><topic>Original Article</topic><topic>Plasma</topic><topic>Propofol - administration & dosage</topic><topic>Prospective Studies</topic><topic>Software</topic><topic>Thoracic surgery</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, N.</creatorcontrib><creatorcontrib>Chazot, T.</creatorcontrib><creatorcontrib>Trillat, B.</creatorcontrib><creatorcontrib>Pirracchio, R.</creatorcontrib><creatorcontrib>Law-Koune, J.-D.</creatorcontrib><creatorcontrib>Barvais, L.</creatorcontrib><creatorcontrib>Fischler, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of anaesthesiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, N.</au><au>Chazot, T.</au><au>Trillat, B.</au><au>Pirracchio, R.</au><au>Law-Koune, J.-D.</au><au>Barvais, L.</au><au>Fischler, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study</atitle><jtitle>European journal of anaesthesiology</jtitle><addtitle>Eur J Anaesthesiol</addtitle><date>2006-06</date><risdate>2006</risdate><volume>23</volume><issue>6</issue><spage>465</spage><epage>469</epage><pages>465-469</pages><issn>0265-0215</issn><eissn>1365-2346</eissn><abstract>Summary Background: This study was designed to evaluate the feasibility of propofol infusion by a closed-loop system for the titration of anaesthetic induction guided by Bispectral Index. Methods: Forty patients were prospectively and randomly allocated into two groups: the target control infusion (TCI) group, where propofol titration was performed manually guided by the Bispectral Index using a commercial pharmacokinetic model (Diprifusor device) and the closed-loop group where titration was performed using a proportional differential algorithm. For both groups, the objective was to achieve a Bispectral Index of 50. Remifentanil TCI was infused at a target of 2 ng mL−1 and was maintained constant throughout the study. Feasibility of automatic induction was evaluated with performance error and haemodynamic data. Results: Bispectral Index overshoot (−9 ± 13% vs. −16 ± 20%, P = 0.035) and mean duration of induction (381 ± 106 s vs. 490 ± 131 s, P = 0.004) were lower in the closed-loop group than in the TCI group. Haemodynamic data were similar between groups with a similar use of ephedrine bolus. Conclusion: The system was able to allow induction clinically for all patients. Automated titration guided by Bispectral Index for propofol infusion was feasible without increase in haemodynamic adverse effects.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>16672092</pmid><doi>10.1017/S0265021506000196</doi><tpages>5</tpages></addata></record> |
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| subjects | Algorithms Anesthesia Anesthesia, General - methods Anesthetics, Intravenous - administration & dosage Beta blockers Blood Pressure - drug effects Clinical medicine Drug Delivery Systems - methods Drug Delivery Systems - statistics & numerical data Drug therapy Electroencephalography - drug effects Electroencephalography - methods Electroencephalography - statistics & numerical data Feasibility Studies Female Heart Rate - drug effects Humans Infusions, Intravenous - methods International standards Male Middle Aged Neurological disorders Original Article Plasma Propofol - administration & dosage Prospective Studies Software Thoracic surgery Ventilation |
| title | Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study |
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