Comparison of the characteristics of sedation using target-controlled infusion and manual infusion of propofol in patients undergoing lower limb surgery under spinal anaesthesia; a randomised controlled trial

IF 1 Q2 Nursing Perioperative Care and Operating Room Management Pub Date : 2025-02-24 DOI:10.1016/j.pcorm.2025.100482

Pinki Kumari, Anju R. Bhalotra, Rahil Singh, Mona Arya, Shweta Dhiman

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Abstract

Background

Conscious sedation during spinal anaesthesia can be achieved by administering propofol using manual controlled infusions (MPI) or target-controlled infusions (TCI). We compared the characteristics of sedation with propofol administered by MPI and TCI in patients undergoing lower limb surgery under spinal anaesthesia.

Methods

A total of 60 patients aged 18–60 years with American Society of Anaesthesiologists physical status 1 and 2 who were scheduled for elective lower limb surgery of an anticipated duration of 1–2 h under spinal anaesthesia were enrolled. Participants were randomly allocated in 1:1 to either Group TCI or Group MPI to receive propofol sedation to maintain OAA/S 3. The primary outcome measure was the recovery time. Secondary outcomes were time to reach the desired level of sedation (OAA/S 3) and the total dose of propofol consumed.

Main results

The mean recovery time was 6.23 ± 1.63 min in the TCI group and 7.30 ± 1.44 min in the MPI group (p = 0.010). The total dose of propofol used in the TCI group (230.07 ± 83.77) was significantly higher than in the MPI group (162.33 ± 62.29) with a p = 0.001. A very strong positive correlation was observed between OAA/S and BIS in the TCI group (r = 0.969) as well as in the MPI group (r = 0.955) with a p < 0.001.

Conclusion

With the study design employed, TCI was associated with a faster recovery and MPI with less propofol consumption. There was a high correlation between OAA/S and BIS values.

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脊柱麻醉下下肢手术患者靶控输注与手动输注异丙酚镇静特点的比较一项随机对照试验

背景：脊髓麻醉期间的有意识镇静可以通过使用手动控制输注（MPI）或靶控制输注（TCI）给药异丙酚来实现。我们比较了脊髓麻醉下下肢手术患者在MPI和TCI下使用异丙酚的镇静特点。方法选取60例年龄在18-60岁，具有美国麻醉学会物理状态1和2的患者，他们计划在脊髓麻醉下进行选择性下肢手术，预计持续时间为1 - 2小时。参与者按1:1的比例随机分配到TCI组或MPI组，接受异丙酚镇静以维持OAA/S 3。主要观察指标为恢复时间。次要结果是达到预期镇静水平的时间（OAA/S 3）和丙泊酚消耗的总剂量。主要结果TCI组平均恢复时间为6.23±1.63 min， MPI组平均恢复时间为7.30±1.44 min （p = 0.010）。TCI组丙泊酚总剂量（230.07±83.77）显著高于MPI组（162.33±62.29），差异有统计学意义（p = 0.001）。TCI组（r = 0.969）和MPI组（r = 0.955） OAA/S与BIS呈极显著正相关(p <；0.001.结论采用该研究设计，TCI与更快的恢复和更少异丙酚消耗的MPI相关。OAA/S与BIS值有较高的相关性。

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.