Target-controlled infusion (TCI) automates the dosing of intravenous drugs during surgery. After the
anesthetist sets the desired parameters in a computer and presses the start button, the system controls the
infusion pump, 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 is the active component of an intravenous anesthetic formulation used for induction and maintenance of general anesthesia. It is chemically termed 2,6-diisopropylphenol. The formulation was approved under the brand name Diprivan. Nu ...
and the synthetic opioid
Remifentanil. 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 describing how the body affects a specific subs ...
studies and use software embedded in the
infusion device. For
propofol
Propofol is the active component of an intravenous anesthetic formulation used for induction and maintenance of general anesthesia. It is chemically termed 2,6-diisopropylphenol. The formulation was approved under the brand name Diprivan. Nu ...
the Marsh and Schnider models are available and the Minto model is commonly used for
remifentanil. 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
propofol
Propofol is the active component of an intravenous anesthetic formulation used for induction and maintenance of general anesthesia. It is chemically termed 2,6-diisopropylphenol. The formulation was approved under the brand name Diprivan. Nu ...
.
See also
*
General anaesthesia#tci
References
Drug delivery devices
General anesthetics
{{medical-equipment-stub