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Target-controlled infusion versus manually-controlled infusion of propofol for general anaesthesia or sedation in adults

Overview of attention for article published in Cochrane database of systematic reviews, July 2016
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Title
Target-controlled infusion versus manually-controlled infusion of propofol for general anaesthesia or sedation in adults
Published in
Cochrane database of systematic reviews, July 2016
DOI 10.1002/14651858.cd006059.pub3
Pubmed ID
Authors

Kate Leslie, Ornella Clavisi, Joshua Hargrove

Abstract

Continuous infusions of the intravenous anaesthetic propofol are commonly used to induce and maintain sedation and general anaesthesia. Infusion devices can be manually controlled (MCI) where the anaesthetist makes each change to the infusion rate or target-controlled (TCI) where the anaesthetist sets a target blood or effect-site concentration and the computerised infusion device makes the necessary changes to the infusion rate. Randomized trials have explored the differences in quality of anaesthesia, adverse event rate and cost between TCI and MCI but the effectiveness of TCI compared with MCI remains controversial. As TCI is in widespread international use, and potentially may be more expensive without added benefit, a systematic review of randomized controlled trials comparing TCI and MCI is warranted. To assess whether TCI of propofol is as effective as MCI of propofol with respect to quality of anaesthesia or sedation, adverse events and propofol drug cost. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 3); PubMED (1950 to July week 2 2007); and EMBASE via OVID (1980 to week 28 2007). We also searched LILACS, CINAHL, ISI Web Knowledge, Panteleimon, KoreaMed and IndMed. We searched for ongoing trials via the National Research Register and metaRegister of Controlled Trials. We planned to include all published and unpublished randomized controlled trials that compared TCI of propofol with MCI of propofol for general anaesthesia or sedation in adult surgical patients. Only published studies were included as no unpublished studies were identified. Two authors independently assessed trial quality and extracted outcome data. We contacted study authors and the pharmaceutical industry for additional information. Twenty trials of poor quality that involved 1759 patients were included. Heterogeneity was high (that is the trials were not comparing the same things). TCI was associated with higher total doses of propofol than was MCI resulting in marginally higher propofol drug costs. However, fewer interventions were required by the anaesthetist during the use of TCI compared with MCI. No clinically significant differences were demonstrated in terms of quality of anaesthesia or adverse events. This systematic review does not provide sufficient evidence for us to make firm recommendations about the use of TCI versus MCI in clinical anaesthetic practice.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 4 9%
Italy 1 2%
Canada 1 2%
Unknown 37 86%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 7 16%
Researcher 6 14%
Other 6 14%
Student > Bachelor 4 9%
Student > Doctoral Student 4 9%
Other 14 33%
Unknown 2 5%
Readers by discipline Count As %
Medicine and Dentistry 24 56%
Neuroscience 4 9%
Nursing and Health Professions 3 7%
Engineering 2 5%
Agricultural and Biological Sciences 1 2%
Other 5 12%
Unknown 4 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 September 2016.
All research outputs
#11,143,469
of 12,527,219 outputs
Outputs from Cochrane database of systematic reviews
#8,923
of 8,923 outputs
Outputs of similar age
#216,191
of 259,765 outputs
Outputs of similar age from Cochrane database of systematic reviews
#128
of 135 outputs
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We're also able to compare this research output to 135 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.