Hemodynamic Response to Induction and Intubation with Bolus Propofol Injection and Effect-site Target Controlled Infusion with Two Pharmacokinetic Models
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Abstract
Background: Propofol, a sedative-hypnotic agent, is associated with hemodynamic stability. Different anesthetic induction techniques by propofol will produce different hemodynamic responses. The objective of the study is to compare the hemodynamic changes during anesthesia induction between 3 different induction methods. Methods: One hundred and sixty two patients who underwent elective surgery under general anesthesia were randomly assigned to three groups. The patients received propofol by Bolus injection, Schnider model and Marsh model. Blood pressure and heart rate were recorded before induction, after induction and every minute during the first 5 minutes after intubation. Induction time and dose of propofol were recorded. Results: Time to eyelash reflex loss and dose of propofol were significantly higher in Marsh model than Bolus injection and Schnider model group. Through the first 5 minutes after tracheal intubation, the blood pressure of Marsh model group was significantly lower than Bolus injection and Schnider model group. Neither heart rate nor oxygen saturation were significantly different between the three groups. Marsh model produce less hemodynamic changes than Bolus injection and Schnider model. Conclusion: Propofol-anesthesia administered via Marsh model TCI produced better hemodynamic stability than Bolus injection and Schnider model.
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