Anesthesia using target-controlled infusion of propofol during elective pediatric surgery: Kataria versus Paedfusor pharmacokinetic model

Abstract

Background: Kataria and Paedfusor are two validated target-controlled infusion (TCI) pharmacokinetic (PK) models in pediatric population. The aim of this study was to compare the effectiveness of these two different PK models of TCI in pediatric patients during elective surgery.
Methodology: 38 patients of ASA I and II, aged 3-12 year-old, who underwent elective surgery under general anesthesia, were randomized into two groups; Group Kataria (Group K) (n = 19) and Group Paedfusor (Group P) (n = 19). All patients initially received 1 µg/kg loading dose of intravenous (IV) remifentanil over 1 minute 15 seconds and followed with infusion at 0.1-1 µg/kg/min. Group K was subsequently started with Kataria model at target plasma concentration (Cpt) of 6 µg/ml, whereas Group P was started with Paedfusor model also at Cpt of 6 µg/ml. Success rate of induction and induction time were recorded. Anesthesia for both groups was maintained at Cpt of 3-6 µg/ml. After completion of surgery, remifentanil infusion and TCI propofol were stopped. Recovery time and plasma concentration (Cp) of propofol at recovery were recorded.
Results: All patients in both groups were successfully induced at Cpt of 6 µg/ml and induction time was also comparable. Cp at recovery was significantly lower in Group K than Group P; [1.5 ± 0.1 vs. 1.6 ± 0.1; p = 0.01]. However, there was no significant difference in time of recovery.
Conclusions: Kataria and Paedfusor PK models were comparably effective for induction of anesthesia and recovery of pediatric patients. However, Cp at recovery was lower in Kataria than Paedfusor model.