Safety of patient-maintained propofol sedation using a target-controlled system in healthy volunteers.


Journal Article

We investigated the safety of a patient-maintained system that allows individuals to operate a target-controlled infusion of propofol to achieve sedation. Ten healthy volunteers were recruited and instructed to try to anaesthetize themselves with the system. A target-controlled infusion of propofol was set to deliver a target propofol concentration of 1 microgram ml-1, and the subjects allowed to increase the target in increments of 0.2 microgram ml-1 by pressing a control button twice in 1 s. There was a lockout time of 2 min and a maximum permitted target concentration of 3 micrograms ml-1. Heart rate and pulse oximetry oxygen saturation (SpO2) were monitored continuously, and non-invasive arterial pressure, ventilatory frequencies and sedation scores were measured every 5 min. Sedation was continued until the subject stopped pressing the button. A keyword was then read for the individual to remember and sedation discontinued. There were no instances of significant decrease of SpO2 or loss of airway control. Maximum target blood concentration of propofol recorded ranged from 1.4 to 3 micrograms ml-1. Two subjects became oversedated, one of whom was unrousable with loss of eyelash reflex. No subject could recall the keyword, although one recognized it from a list of 10 words. We conclude that the patient-maintained sedation system described could not be guaranteed to produce only conscious sedation in all patients, and that close clinical supervision by an anaesthetist would still be required for safe operation.

Full Text

Cited Authors

  • Murdoch, JA; Grant, SA; Kenny, GN

Published Date

  • August 2000

Published In

Volume / Issue

  • 85 / 2

Start / End Page

  • 299 - 301

PubMed ID

  • 10992841

Pubmed Central ID

  • 10992841

Electronic International Standard Serial Number (EISSN)

  • 1471-6771

International Standard Serial Number (ISSN)

  • 0007-0912

Digital Object Identifier (DOI)

  • 10.1093/bja/85.2.299


  • eng