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Journal of Clinical Monitoring and Computing (2006) 20: 109115
DOI: 10.1007/s10877-006-9014-3 C Springer 2006McGaughran L, Voss LJ, Oliver R, Petcu M, Schaare P, Barnard JPM,
Sleigh JW. Rapid measurement of blood propofol levels: A proof of
concept study.J Clin Monit Comput 2006; 20: 109115ABSTRACT. Objective: Despite many advantages over traditional
volatile anaesthetic techniques, propofol total intravenous anaesthesia (TIVA) makes up a small percentage of general anaesthetics administered. One of the reasons for this is the absence of
a clinically useful method for measuring blood propofol concentrations. We have designed and tested a prototype system for
rapidly measuring blood plasma levels of propofol using solid
phase extraction (SPE) methodology, coupled with colorimetric and spectrometric techniques. Methods: Multiple venous
blood samples were taken from 17 subjects during induction of
anaesthesia with propofol. Samples were analysed in duplicate
on both the prototype system and using High Performance Liquid Chromatography (HPLC). The prototype monitor response
was calibrated against known methanol-based propofol standards
and an estimate of the plasma concentration of propofol derived
from regression analysis of the standard responses. Results: Bland
Altman analysis from a total of 87 samples gave 95% limits of
agreement between the two methods of 0.34 to 0.42 gmLRAPID MEASUREMENT OF BLOOD PROPOFOL
LEVELS: A PROOF OF CONCEPT STUDYL. McGaughran, BAppSc,1 L.J. Voss, PhD,2 R. Oliver,
MSc,3 M. Petcu, P. Schaare, PhD,3 J.P.M. Barnard,
MBChB, FANZCA,2 and J.W. Sleigh, MD, MBChB,
FANZCA21(with no significant bias). The mean absolute prediction error
was 8.9(7.5)%. The run time per sample on the prototype system was 4.5 min, including sample preparation. Conclusion:
The results show that this methodology may be suitable for rapid
and accurate clinical monitoring of propofol levels during general
anaesthesia.KEY WORDS. propofol, total intravenous anaesthesia, spectrometry,
colorimetry, general anaesthesia, measurement.INTRODUCTIONGeneral anaesthesia utilising intravenous agents for both
induction and maintenance is termed total intravenous
anaesthesia (TIVA). The use of propofol TIVA has been
shown to have many advantages over traditional volatile
anaesthetic techniques. These include significantly reduced
post-operative nausea and vomiting, improved early postoperative patient well-being, and reduced recovery times
[13].Despite its advantages, propofol TIVA makes up only a
small percentage of all general anaesthetics administered.
One of the reasons for this is the absence of a clinically
useful method for measuring blood propofol concentrations. The need...