Target-controlled infusion (TCI) automates the dosing of intravenous drugs during surgery. After the

anesthetist Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...

sets the desired parameters in a computer and presses the start button, the system controls the

infusion pump An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer flu ...

, while being monitored by the anesthetist. TCI is as safe and effective as manually controlled infusion. TCI can be sub-classified according to the target. The suffix 'e' as in TCIe indicates that the target is the effect site, in most cases, the central nervous system or brain. Alternatively, the suffix 'p' denotes plasma, indicating that the device implementing the TCI model is to target the blood plasma. There are important differences in relation to the time taken fo
effect site equilibration
Studies have demonstrated the clinical safety of the effect-site target model. Popular TCI models exist for

Propofol Propofol, marketed as Diprivan, among other names, is a short-acting medication that results in a decreased level of consciousness and a lack of memory for events. Its uses include the starting and maintenance of general anesthesia, sedation ...

and the synthetic opioid

Remifentanil Remifentanil is a potent, short-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is used for sedation as well as combined with other medications fo ...

. The models are based on

pharmacokinetic Pharmacokinetics (from Ancient Greek ''pharmakon'' "drug" and ''kinetikos'' "moving, putting in motion"; see chemical kinetics), sometimes abbreviated as PK, is a branch of pharmacology dedicated to determining the fate of substances administered ...

studies and use software embedded in the

infusion device An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer flu ...

. For

propofol Propofol, marketed as Diprivan, among other names, is a short-acting medication that results in a decreased level of consciousness and a lack of memory for events. Its uses include the starting and maintenance of general anesthesia, sedation ...

the Marsh and Schnider models are available and the Minto model is commonly used for

remifentanil Remifentanil is a potent, short-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is used for sedation as well as combined with other medications fo ...

. In 2017, a project to emulate the TCI models in the python language was published o
GitHub

History

TCI has been used in clinical settings since 1996, initially with

References

Drug delivery devices General anesthetics {{medical-equipment-stub

History

See also

References