The History of Target-Controlled Infusion

Target-controlled infusion (TCI) is a technique of infusing IV drugs to achieve a user-defined predicted (“target”) drug concentration in a specific body compartment or tissue of interest. In this review, we describe the pharmacokinetic principles of TCI, the development of TCI systems, and technical and regulatory issues addressed in prototype development. We also describe the launch of the current clinically available systems.

[1]  H Schwilden,et al.  Pharmacokinetics as applied to total intravenous anaesthesia , 1983, Anaesthesia.

[2]  J. Sear,et al.  Pharmacokinetics of propofol ('Diprivan') as an induction agent. , 1985, Postgraduate medical journal.

[3]  D R Stanski,et al.  An evaluation of the accuracy of pharmacokinetic data for the computer assisted infusion of alfentanil. , 1985, British journal of anaesthesia.

[4]  A. Burm,et al.  Computer-Controlled Infusion of Alfentanil Versus Patient-Controlled Administration of Morphine for Postoperative Analgesia: A Double-Blind Randomized Trial , 1995, Anesthesia and analgesia.

[5]  C. Swinhoe,et al.  Target controlled infusion of ketamine as analgesia for TIVA with propofol , 1999, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[6]  R. Farinotti,et al.  Pharmacokinetics of propofol infusions in patients with cirrhosis. , 1991, British journal of anaesthesia.

[7]  M. Struys,et al.  The Safety of Target-Controlled Infusions , 2016, Anesthesia and analgesia.

[8]  Thomas W. Schnider,et al.  Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. I. Model development , 1997 .

[9]  P. Glass,et al.  Alfentanil and midazolam: new anesthetic drugs for continuous infusion and an automated method of administration. , 1989, The Mount Sinai journal of medicine, New York.

[10]  J. Glen The development and future of target controlled infusion. , 2003, Advances in experimental medicine and biology.

[11]  S L Shafer,et al.  Influence of Age and Gender on the Pharmacokinetics and Pharmacodynamics of Remifentanil: I. Model Development , 1997, Anesthesiology.

[12]  E. Olofsen,et al.  Pharmacodynamic Interaction between Propofol and Alfentanil When Given for Induction of Anesthesia , 1996, Anesthesiology.

[13]  Donald R. Stanski,et al.  Comparison of a Computer‐assisted Infusion Versus Intermittent Bolus Administration of Alfentanil as a Supplement to Nitrous Oxide for Lower Abdominal Surgery , 1988, Anesthesiology.

[14]  S. Shafer,et al.  A comparison of parametric with semiparametric analysis of the concentration versus effect relationship of metocurine in dogs and pigs , 1989, Journal of Pharmacokinetics and Biopharmaceutics.

[15]  James C. Scott,et al.  Testing computer-controlled infusion pumps by simulation. , 1988, Anesthesiology.

[16]  M. Struys,et al.  Pharmacokinetic models for propofol--defining and illuminating the devil in the detail. , 2009, British journal of anaesthesia.

[17]  N. Morton,et al.  Pharmacokinetic model driven infusion of propofol in children. , 1991, British journal of anaesthesia.

[18]  L B Sheiner,et al.  Simultaneous modeling of pharmacokinetics and pharmacodynamics: application to d-tubocurarine. , 1980, Clinical pharmacology and therapeutics.

[19]  Hugo Vereecke,et al.  An Evaluation of Using Population Pharmacokinetic Models to Estimate Pharmacodynamic Parameters for Propofol and Bispectral Index in Children , 2011, Anesthesiology.

[20]  E. Krüger-Thiemer,et al.  Continuous intravenous infusion and multicompartment accumulation. , 1968, European journal of pharmacology.

[21]  S. Harapat,et al.  Plasma Concentration Clamping in the Rat Using a Computer-Controlled Infusion Pump , 1992, Pharmaceutical Research.

[22]  A Sibbald,et al.  A pharmacodynamic model for pancuronium. , 1978, British journal of anaesthesia.

[23]  M. White,et al.  Intravenous propofol anaesthesia using a computerised infusion system , 1990, Anaesthesia.

[24]  J.M. Bailey,et al.  A simple analytical solution to the three-compartment pharmacokinetic model suitable for computer-controlled infusion pumps , 1991, IEEE Transactions on Biomedical Engineering.

[25]  Michel M R F Struys,et al.  Target-Controlled Infusion: A Mature Technology , 2016, Anesthesia and analgesia.

[26]  K. Leslie,et al.  Target-Controlled Infusion Versus Manually-Controlled Infusion of Propofol for General Anaesthesia or Sedation in Adults , 2008, Anesthesia and analgesia.

[27]  S. Shafer,et al.  The Influence of Method of Administration and Covariates on the Pharmacokinetics of Propofol in Adult Volunteers , 1998, Anesthesiology.

[28]  S. Shafer,et al.  A simple pocket calculator approach to predict anesthetic drug concentrations from pharmacokinetic data. , 1990, Anesthesiology.

[29]  J. Glen,et al.  Pharmacokinetic model selection for target controlled infusions of propofol. Assessment of three parameter sets. , 1994 .

[30]  J.R. Jacobs,et al.  Analytical solution to the three-compartment pharmacokinetic model , 1988, IEEE Transactions on Biomedical Engineering.

[31]  H. Schwilden,et al.  Quantitation of the EEG and pharmacodynamic modelling of hypnotic drugs: etomidate as an example. , 1985, European journal of anaesthesiology.

[32]  D R Stanski,et al.  Population pharmacokinetics of alfentanil: the average dose-plasma concentration relationship and interindividual variability in patients. , 1987, Anesthesiology.

[33]  J. Glen,et al.  The development of ‘Diprifusor’: a TCI system for propofol , 1998, Anaesthesia.

[34]  J. R. Jacobs,et al.  Algorithm for optimal linear model-based control with application to pharmacokinetic model-driven drug delivery , 1990, IEEE Transactions on Biomedical Engineering.

[35]  S L Shafer,et al.  The influence of age on propofol pharmacodynamics. , 1999, Anesthesiology.

[36]  S L Shafer,et al.  Nomenclature for computer-assisted infusion devices. , 1997, Anesthesiology.

[37]  K. Leslie,et al.  Effect‐site targeted patient‐controlled sedation with propofol: comparison with anaesthetist administration for colonoscopy , 2006, Anaesthesia.

[38]  D. Stanski,et al.  Linearity of Pharmacokinetics and Model Estimation of Sufentanil , 1995, Anesthesiology.

[39]  Ausems Me,et al.  Plasma concentrations of alfentanil required to supplement nitrous oxide anaesthesia for lower abdominal surgery. , 1983, British journal of anaesthesia.

[40]  E. Williams,et al.  Algorithm to control "effect compartment" drug concentrations in pharmacokinetic model-driven drug delivery , 1993, IEEE Transactions on Biomedical Engineering.

[41]  Erik M. P. Widmark,et al.  Studies in the concentration of indifferent narcotics in blood and tissues , 2009 .

[42]  J T Harvey,et al.  Computer controlled infusion of propofol. , 1989, British journal of anaesthesia.

[43]  Thomas W. Schnider,et al.  Pharmacokinetics and Pharmacodynamics of Remifentanil , 1997 .

[44]  H F Nicodemus,et al.  The Pharmacokinetics of Propofol in Children Using Three Different Data Analysis Approaches , 1994, Anesthesiology.

[45]  G. Tucker,et al.  General derivation of the ideal intravenous drug input required to achieve and maintain a constant plasma drug concentration. Theoretical application to lignocaine therapy , 2004, European Journal of Clinical Pharmacology.

[46]  G. Tucker,et al.  General theory for rapidly establishing steady state drug concentrations using two consecutive constant rate intravenous infusions , 1975, European Journal of Clinical Pharmacology.

[47]  C. Hug,et al.  Variable Rate Infusion of Alfentanil as a Supplement to Nitrous Oxide Anesthesia for General Surgery , 1983, Anesthesia and analgesia.

[48]  T. Jannett Computer-assisted continuous infusion of the intravenous analgesic fentanyl during general anesthesia--an interactive system. , 1986, IEEE transactions on bio-medical engineering.

[49]  H Schwilden,et al.  Total intravenous anaesthesia with propofol and alfentanil by computer‐assisted infusion , 1988, Anaesthesia.

[50]  S. Shafer,et al.  Variability of Target-controlled Infusion Is Less Than the Variability after Bolus Injection , 2005, Anesthesiology.

[51]  J. Glen,et al.  Pharmacokinetic Model Selection for Target Controlled Infusions of Propofol: Assessment of Three Parameter Sets , 1994, Anesthesiology.

[52]  James C. Scott,et al.  Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. , 1990, Anesthesiology.

[53]  M. Struys,et al.  Comparison of Plasma Compartment versus Two Methods for Effect Compartment–controlled Target-controlled Infusion for Propofol , 2000, Anesthesiology.

[54]  Michel M. R. F. Struys,et al.  The Accuracy and Clinical Feasibility of a New Bayesian-Based Closed-Loop Control System for Propofol Administration Using the Bispectral Index as a Controlled Variable , 2008, Anesthesia and analgesia.

[55]  S L Shafer,et al.  Pharmacokinetics and Pharmacodynamics of Remifentanil: II. Model Application , 1997, Anesthesiology.

[56]  Steven L. Shafer,et al.  Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump , 1992, Journal of Pharmacokinetics and Biopharmaceutics.

[57]  D R Stanski,et al.  EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. , 1985, Anesthesiology.

[58]  C. Hug,et al.  Plasma concentrations of alfentanil required to supplement nitrous oxide anaesthesia for lower abdominal surgery. , 1983, British journal of anaesthesia.

[59]  S E Judge,et al.  Effect of general anaesthetics on synaptic ion channels. , 1983, British journal of anaesthesia.

[60]  G N Kenny,et al.  Development of the technology for ‘Diprifusor’ TCI systems , 1998, Anaesthesia.

[61]  Michel M. R. F. Struys,et al.  Estimation of Optimal Modeling Weights for a Bayesian-Based Closed-Loop System for Propofol Administration Using the Bispectral Index as a Controlled Variable: A Simulation Study , 2007, Anesthesia and analgesia.

[62]  M. White,et al.  Accuracy of the 'Paedfusor' in children undergoing cardiac surgery or catheterization. , 2003, British journal of anaesthesia.

[63]  D R Stanski,et al.  Evaluating the Accuracy of Using Population Pharmacokinetic Data to Predict Plasma Concentrations of Alfentanil , 1988, Anesthesiology.

[64]  D R Stanski,et al.  Decreased fentanyl and alfentanil dose requirements with age. A simultaneous pharmacokinetic and pharmacodynamic evaluation. , 1987, The Journal of pharmacology and experimental therapeutics.

[65]  C. Nazar,et al.  Estimation of the plasma effect-site equilibration rate constant (ke0) of rocuronium by the time of maximum effect: a comparison with non-parametric and parametric approaches. , 2007, British journal of anaesthesia.

[66]  J A Spain,et al.  Computer‐assisted Continuous Infusions of Fentanyl during Cardiac Anesthesia: Comparison with a Manual Method , 1985, Anesthesiology.

[67]  Michel M. R. F. Struys,et al.  A General Purpose Pharmacokinetic Model for Propofol , 2014, Anesthesia and analgesia.

[68]  D R Stanski,et al.  Bayesian Forecasting Improves the Prediction of Intraoperative Plasma Concentrations of Alfentanil , 1988, Anesthesiology.

[69]  V. Iyer Microlaryngeal surgery. , 1979, Anaesthesia and intensive care.

[70]  J. Egmond,et al.  Comparison of etomidate and propofol for anaesthesia in microlaryngeal surgery , 1987, Anaesthesia.

[71]  H. Schwilden,et al.  Infusion strategies to investigate the pharmacokinetics and pharmacodynamics of hypnotic drugs: etomidate as an example. , 1985, European journal of anaesthesiology.

[72]  Steven L Shafer,et al.  Using the Time of Maximum Effect Site Concentration to Combine Pharmacokinetics and Pharmacodynamics , 2003, Anesthesiology.

[73]  H. Schwilden,et al.  A general method for calculating the dosage scheme in linear pharmacokinetics , 2004, European Journal of Clinical Pharmacology.