Target-controlled infusion of propofol for fibreoptic intubation.
OBJECTIVE
In a retrospective study, we examined the suitability of a departmental clinical protocol for anaesthesia induction with target-controlled infusion of propofol developed for fibreoptic intubation in spontaneously breathing patients scheduled for outpatient oral surgery at the dental clinic of the Vienna University Hospital.


METHODS
Propofol was administered using target-controlled infusion (Diprifusor) at increasing target plasma concentrations starting at 2.5 microg mL(-1). After 10 min, an intravenous dose of alfentanil (5-10 microg kg(-1)) was given for pain reduction. After a further 2 min, the patient was evaluated for response to auditory stimulation. If unresponsive, fibreoptic intubation was performed, otherwise the target concentration was increased by 0.2 microg mL(-1) every 2 min until non-responsiveness was attained.


RESULTS
Tracheal intubation was successful in all patients without any haemodynamic instability. However, one patient required facemask ventilation for 2 min. No patient was aware of intubation. The plasma concentration required for non-responsiveness was 2.8 +/- 0.4 microg mL(-1) (mean +/- SD).


CONCLUSIONS
When using a target-controlled infusion of propofol, fibreoptic intubation can be performed with complete amnesia of the procedure for the patient. However, assisted ventilation of the lungs may be necessary as spontaneous ventilation may cease.
Knolle
E
E
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria. erich.knolle@univie.ac.at
Oehmke
M J
MJ
Gustorff
B
B
Hellwagner
K
K
Kress
H G
HG
D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006339:Heart Rate; D006801:Humans; D007260:Infusion Pumps; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies
D018686:Anesthetics, Intravenous; D010100:Oxygen; D015742:Propofol