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Clinical Trial
. 2001 Aug;15(4):445-50.
doi: 10.1053/jcan.2001.24979.

Target-controlled infusion or manually controlled infusion of propofol in high-risk patients with severely reduced left ventricular function

A Lehmann  1 , J Boldt, R Römpert, E Thaler, B Kumle, U Weisse
Affiliations
Clinical Trial

Target-controlled infusion or manually controlled infusion of propofol in high-risk patients with severely reduced left ventricular function

A Lehmann et al. J Cardiothorac Vasc Anesth. 2001 Aug.

Retraction in

  • Retractions.
    [No authors listed] [No authors listed] J Cardiothorac Vasc Anesth. 2011 Aug;25(4):755-7. J Cardiothorac Vasc Anesth. 2011. PMID: 22013600 No abstract available.

Abstract

Objective: To compare hemodynamics, time to extubation, and costs of target-controlled infusion (TCI) with manually controlled infusion (MCI) of propofol in high-risk cardiac surgery patients.

Design: Prospective, randomized.

Setting: Major community university-affiliated hospital.

Participants: Twenty patients undergoing first-time implantation of a cardioverter-defibrillator with severely reduced left ventricular function (left ventricular ejection fraction <30%).

Interventions: Anesthesia was performed using remifentanil, 0.2 to 0.3 microg/kg/min, and propofol. Propofol was used as TCI (plasma target concentration, 2 to 3 microg x mL; n = 10) or MCI (2.5 to 3.5 mg/kg/hr; n = 10).

Measurements and main results: Hemodynamics were measured at 6 data points: T1, before anesthesia; T2, after intubation; T3, after skin incision; T4, after first defibrillation; T5, after third defibrillation; and T6, after extubation. There were no significant hemodynamic differences between the 2 groups. Dobutamine was required to maintain cardiac index >2 L/min/m(2) in significantly more patients of the TCI group than of the MCI group. Mean dose of propofol was higher in the TCI patients (6.0 +/- 1.0 mg/kg/hr) than in the MCI patients (3.0 +/- 0.4 mg/kg/hr) (p < 0.05), whereas doses of remifentanil did not differ. Time to extubation was significantly shorter in the MCI (11.9 +/- 2.4 min) versus the TCI group (15.6 +/- 6.8 min). Costs were significantly lower in MCI patients (34.73 dollars) than in TCI patients (44.76 dollars).

Conclusions: In patients with severely reduced left ventricular function, TCI and MCI of propofol in combination with remifentanil showed similar hemodynamics. TCI patients needed inotropic support more often than MCI-treated patients. Although extubation time was longer in TCI patients and costs were higher, both anesthesia techniques can be recommended for early extubation after implantation of a cardioverter-defibrillator.

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