Feasibility Analysis Of Target-controlled Infusion With Propofol For Sedation In ICU Patients Undergoing Mechannical Ventilation

Objective:In the present study, we aimed to investigate the application value of target-controlled infusion (TCI) by the comparison between TCI and intravenous continuous infusion with Propofol for sedation in ICU patients undergoing mechannical ventilation.Methods:Sixty patients in ICU undergoing mechannical ventilation were randomly divided into two groups with thirty cases each. Patients in group I received intravenous continuous infusion of propofol. The patients in group II were sedated by propofol TCI. The depth of sedation was maintained at SAS scores of3-4by regulating the infusion rate or target plasma concentration, we investigated the convenience of use and sedation efficiency by comparing the adjustment rate of dose and the variation of BIS values. Continuously we monitored respiration, heart rate, mean blood pressure at each observation point during sedation for comparison of hemodynamics. At the beginning and the end of sedation, the PH values of gastric juice and the plasma ACTH were recorded to compare the influence to stress. The required time of call respond after sedation and SAS scores at five minutes after tracheal extubation were recorded to compare the influence to stress. The total amount of propofol administered were recorded to evaluate the substantial benefit of each method.Results:There were no significant differences in respiration, heart rate, mean blood pressure across groups or within group (P>0.05). The percent of times adjustment in target-controlled infusion group (9.10%) was less than that in continuous infusion group (23.60%)(P<0.05). There were no significant differences in BIS values across groups (P>0.05), but the coefficient of variation of BIS values in group I was obviously higher than it in group Ⅱ (P<0.01). There were no significant differences in the PH values of gastric juice and the plasma ACTH concentration across groups (P>0.05) either the beginning or the end of sedation, but they were significant differences between the beginning and the end of sedation within groups (P<0.05). The required time of call respond in group I was longer than it in group II (P<0.05).There were no significant differences in SAS scores at five minutes after tracheal extubation between two groups (P>0.05).There were no significant differences in dose of Propofol between two groups (P>0.05).Conclusion:TCI with propofol for sedation of ICU patients is feasible. Compared with continuous infusion, it is convenient to use and can have the sedation not only more stable but also easy to controll. The two methods to dose of propofol have similar substantial benefit during short-time sedation, and it is not clear that TCI is better in reducing the stress or improve the wakefulness after tracheal extubation.