الفهرس 
Target Controlled Infusion SystemOnly 14 pages are availabe for public view
 |  | from | 105 |  |  |
| | | from | 105 | | |
Abstract
The progress in computing technology has allowed the development of target controlled infusion devices, with drugs delivered to achieve specific predicted target blood drug concentrations. Target controlled infusion (TCI) system has been developed as a standardised infusion system for the administration of propofol and opioids as remifentanil and alfentanil by target controlled infusion.
Target controlled infusion is not a system for the complete computer control of anesthesia, the control still with the anesthetist who adjust the target drug concentration according to the clinical needs.
The benefits of target controlled infusion system can be considered mainly in the term of convenience of use, as its simple in use, displays the calculated and the effect-site drug concentration, displays the predicted patient waking time and avoid the need for time consuming calculations.
Also, There is evidence that target controlled infusion systems can improve certain outcomes as the depth of anesthesia, intraoperative hemodynamics and speed of recovery.
A set of pharmacokinetic parameters has been selected using computer simulation of a known infusion scheme. The selected model is incorporated into a computer-compatible infusion pump. So, the key components of any target controlled infusion system are: a valid pharmacokinetic model for a specific drug, infusion control algorithm, control unit, infusion pump and user interface.
The launch of Diprifusor as the first commercially available TCI system for propofol was the cornerstone of a successful research period within the last decade, which evaluated the pharmacokinetic foundations of computer assisted intravenous drug delivery. Nowadays TCI technology is becoming a part of routine anesthesia technique for the practitioners who are enthusiasts of intravenous anesthesia.
The distinct pharmacokinetic properties of propofol of rapid onset of action and rapid recovery were a major factor in the development of target controlled infusion system. Administration of propofol using target controlled infusion system can speed the induction of anesthesia or even control the time of induction of anesthesia with a good quality and a good maintainence of anesthesia.
Also, the distinct pharmacokinetic properties of remifentanil of rapid onset of action and short duration of action make it an ideal drug for target controlled infusion and many anesthetists now consider the combination of propofol TCI and remifentanil TCI is the best anesthetic combination.
Alfentanil administration via target controlled infusion system is an optimal solution for post-operative analgesia as a form of patient controlled analgesia with the advantage of rapid achievement of analgesic blood concentration and rapid onset of analgesia.