Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul-Sep;40(3):371-380.
doi: 10.4103/joacp.joacp_64_23. Epub 2023 Aug 16.

Target-controlled infusion - Past, present, and future

Prasanna Udupi Bidkar  1 , Ankita Dey  2 , Protiti Chatterjee  1 , Rajasekar Ramadurai  1 , Jerry Jame Joy  1
Affiliations
Review

Target-controlled infusion - Past, present, and future

Prasanna Udupi Bidkar et al. J Anaesthesiol Clin Pharmacol. 2024 Jul-Sep.

Abstract

Target-controlled infusion (TCI) is a novel drug delivery system wherein a microprocessor calculates the rate of drug to be infused based upon the target plasma or effect site concentration set by the operator. It has found its place in the operation theaters and intensive care units (ICUs) for safe administration of intravenous anesthesia and analgosedation using drugs like propofol, dexmedetomidine, opioids, and so on. Operating a TCI device requires the user to have a primitive understanding of drug pharmacokinetics and pharmacodynamics and an awareness of the practical problems that can arise during its administration. Ongoing research supports their usage in other clinical settings and for various other drugs such as antibiotics, vasopressors, and so on. In this article, we review the underlying principles and commonly used drugs for TCI, the practical aspects of its implementation, and the scope of this technology in future. TCI technology is increasingly being used in the field of anesthesiology and critical care due to the myriad advantages it offers when compared to manual infusions. It is, therefore, essential for the reader to understand the relevant principles and practical aspects related to TCI technology, as well as to be aware of the commonly used TCI models.

Keywords: Compartment model; pharmacodynamics; pharmacokinetics; propofol; target-controlled infusion.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Plasma concentration of drug minutes after a bolus injection
Figure 2
Figure 2
The three-compartment model V1: central compartment, V2: rapidly equilibrating, well-perfused tissue group, V3: slowly equilibrating, poorly perfused tissue group, k12: rate constant between V1 and V2, k21: rate constant between V2 and V1, k13: rate constant between V1 and V3, k31: rate constant between V3 and V1, k10: rate constant for drug elimination from V1
Figure 3
Figure 3
Components of TCI TCI = target-controlled infusion
Figure 4
Figure 4
The three elements in a TCI apparatus TCI = target-controlled infusion
See this image and copyright information in PMC

References

    1. Schüttler J, Kloos S, Schwilden H, Stoeckel H. Total intravenous anaesthesia with propofol and alfentanil by computer-assisted infusion. Anaesthesia. 1988;43((Suppl)):2–7. - PubMed
    1. Tackley RM, Lewis GTR, Prys-Roberts C, Boaden RW, Dixon J, Harvey JT. Computer controlled infusion of propofol. Br J Anaesth. 1989;62:46–53. - PubMed
    1. Jacobs JR. Analytical solution to the three-compartment pharmacokinetic model. IEEE Trans Biomed Eng. 1988;35:763–5. - PubMed
    1. Shafer SL, Varvel JR, Aziz N, Scott JC. Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. Anesthesiology. 1990;73:1091–102. - PubMed
    1. Kenny GN, White M. A portable target controlled propofol infusion system. J Clin Monit Comput. 1992;9:179–82. - PubMed

LinkOut - more resources