A prototype patient-maintained propofol sedation system using target controlled infusion for primary lower-limb arthroplasty

Sprinks, J. ORCID: 0000-0003-3781-5484, Worcester, F. ORCID: 0000-0003-4616-6842, Breedon, P. ORCID: 0000-0002-1006-0942, Watts, P. ORCID: 0000-0002-0133-6687, Hewson, D. and Bedforth, N., 2019. A prototype patient-maintained propofol sedation system using target controlled infusion for primary lower-limb arthroplasty. Journal of Medical Systems, 43 (8): 247. ISSN 0148-5598

[img]
Preview
Text
14175_Sprinks.pdf - Published version

Download (2MB) | Preview

Abstract

Each year, many operations in the UK are performed with the patient awake, without the use of general anaesthesia. These include joint replacement procedures, and in order to reduce patient anxiety, the supervising anaesthetist delivers the sedative propofol intravenously using a target-controlled infusion (TCI) device. However, it is clinically challenging to judge the required effect-site concentration of sedative for an individual patient, resulting in patient care issues related to over or under-sedation. To improve the process, patient-maintained propofol sedation (PMPS), where the patient can request an increase in concentration through a hand-held button, has been considered as an alternative. However, due to the proprietary nature of modern TCI pumps, the majority of PMPS research has been conducted using prototypes in research studies. In this work, a PMPS system is presented that effectively converts a standard infusion pump into a TCI device using a laptop with TCI software. Functionally, the system delivers sedation analogous to a modern TCI pump, with the differences in propofol consumption and dosage within the tolerance of clinically approved devices. Therefore, the Medicines and Healthcare products Regulatory Agency (MHRA) has approved the system as a safe alternative to anaesthetist-controlled TCI procedures. It represents a step forward in the consideration of PMPS as a sedation method as viable alternative, allowing further assessment in clinical trials.

Item Type: Journal article
Publication Title: Journal of Medical Systems
Creators: Sprinks, J., Worcester, F., Breedon, P., Watts, P., Hewson, D. and Bedforth, N.
Publisher: Springer
Date: August 2019
Volume: 43
Number: 8
ISSN: 0148-5598
Identifiers:
NumberType
10.1007/s10916-019-1377-3DOI
1377Publisher Item Identifier
Rights: © The Author(s) 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Divisions: Schools > School of Architecture, Design and the Built Environment
Depositing User: Linda Sullivan
Date Added: 28 Jun 2019 11:44
Last Modified: 28 Jun 2019 11:44
URI: http://irep.ntu.ac.uk/id/eprint/36955

Actions (login required)

Edit View Edit View

Views

Views per month over past year

Downloads

Downloads per month over past year