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Target-controlled infusion of propofol for fibreoptic intubation

Published online by Cambridge University Press:  11 July 2005

E. Knolle ,
M. J. Oehmke ,
B. Gustorff ,
K. Hellwagner  and
H. G. Kress
E. Knolle
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
M. J. Oehmke
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
B. Gustorff
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
K. Hellwagner
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
H. G. Kress
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
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Extract

Summary

Background and objective: In a retrospective study, we examined the suitability of a departmental clinical protocol for anaesthesia induction with target-controlled infusion of propofol developed for fibreoptic intubation in spontaneously breathing patients scheduled for outpatient oral surgery at the dental clinic of the Vienna University Hospital.

Methods: Propofol was administered using target-controlled infusion (Diprifusor®) at increasing target plasma concentrations starting at 2.5 μg mL−1. After 10 min, an intravenous dose of alfentanil (5–10 μg kg−1) was given for pain reduction. After a further 2 min, the patient was evaluated for response to auditory stimulation. If unresponsive, fibreoptic intubation was performed, otherwise the target concentration was increased by 0.2 μg mL−1 every 2 min until non-responsiveness was attained.

Results: Tracheal intubation was successful in all patients without any haemodynamic instability. However, one patient required facemask ventilation for 2 min. No patient was aware of intubation. The plasma concentration required for non-responsiveness was 2.8 ± 0.4 μg mL−1 (mean ± SD).

Conclusions: When using a target-controlled infusion of propofol, fibreoptic intubation can be performed with complete amnesia of the procedure for the patient. However, assisted ventilation of the lungs may be necessary as spontaneous ventilation may cease.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolINTUBATION, INTRATRACHEALOPTICS, fibreopticsPHARMACOKINETICS, target-controlled infusionSEDATION, amnesia
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 7 , September 2003 , pp. 565 - 569
Copyright
© 2003 European Society of Anaesthesiology

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