A target-controlled infusion system automatically adjusts the rate of infusion of propofol to maintain a desired concentration.
In this study, physicians from Italy determined whether the administration of propofol using a target-controlled infusion system improved sedation in patients undergoing ERCP.
The team assessed 205 consecutive patients undergoing ERCP. Patients were sedated by an anesthesiologist using a propofol target-controlled infusion system.
The target plasma concentration of propofol ranged from 2 to 5 µg/mL.
|There were no severe complications.|
The patients were also given a bolus dose of fentanyl (50-100 mcg) if signs of insufficient analgesia were observed.
The team graded the technical difficulty of ERCP from 1 (least difficult) to 5 (most difficult).
The physicians found that mean dose of propofol was 465 mg and the mean dose of fentanyl was 59 mcg.
They determined that the total dose of propofol and the mean duration of ERCP were related to the degree of difficulty of the procedure.
The team did not observe any severe complications.
They found that the time to discharge was not influenced by the difficulty of ERCP or by the total dose of propofol administered.
Dr Lorella Fanti and colleagues concluded, "A target-controlled infusion system for administration of propofol provides safe and effective sedation during ERCP".
"Further studies are needed to determine the cost-effectiveness and the safety profile for infusion of propofol with a target-controlled infusion system by a nonanesthesiologist during ERCP."