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Effect‐site controlled patient maintained propofol sedation: a volunteer safety study *
Author(s) -
Anderson K. J.,
Leitch J. A.,
Green J. S.,
Kenny G. N. C.
Publication year - 2005
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2004.04071.x
Subject(s) - medicine , sedation , propofol , volunteer , anesthesia , surgery , biology , agronomy
Summary Effect‐site concentration is a mathematical term related to the clinical effect of a drug. We have designed a patient‐maintained sedation system for delivering propofol to the predicted effect‐site concentration rather than plasma concentration. To assess its efficacy and safety, 20 healthy volunteers deliberately attempted to over‐sedate themselves using the system. The new effect‐site concentration driven system delivered sedation successfully, and more rapidly than its predecessor. Fifteen volunteers ended the study when the system automatically reduced the effect‐site concentration after 6 min of no button presses despite verbal contact and maintenance of arterial oxygen saturation (at effect‐site concentration 1.8–3.8 μg.ml −1 ). Four out of 20 volunteers ended with minor arterial desaturation (lowest 88% at effect‐site concentration 2.6–3.4 μg.ml −1 ). One volunteer ended after loss of verbal contact at effect‐site concentration 3.4 μg.ml −1 . Further modification of the system's design is necessary before it can be recommended for routine practice.