What is TCI? Notes on anesthetic control of TCI . target concentration

This is an automatically translated article.

The article is expertly consulted by an Anesthesiologist, anesthesiologist, anesthesiologist - Department of General Surgery & Anesthesia - Vinmec Hai Phong International General Hospital.
TCI is a method of intravenous anesthesia with many outstanding advantages compared to traditional methods of anesthesia. TCI anesthesia techniques help patients achieve appropriate anesthesia, create a feeling of lightness after waking up and especially minimize post-anesthesia complications.

1. What is TCI?

TCI is a method of anesthetic control of the target concentration using software on the electric syringe to determine the concentration of anesthetic drugs acting on the target organs including the patient's brain or plasma at the time of using the anesthetic. .
Target concentration-controlled intravenous anesthesia, if combined with an anesthetic monitoring device (BIS or Entropy), will help the patient achieve an appropriate state of anesthesia, avoiding the patient's need for anesthetic drugs. too much or too little.
TCI target concentration control anesthetic method has been applied in Vietnam since 2001 thanks to a specialized electric syringe. The anesthetic commonly used in TCI intravenous anesthesia is Propofol, today this method is widely used because of its high safety as well as helping doctors predict the time to wake up.

2. Advantages of intravenous anesthesia

TCI target concentration controlled anesthesia has many advantages over traditional methods of anesthesia:
The success rate of this method should be 95%, achieve quickly and maintain the level of anesthesia Desired anesthesia of each type of anesthetic minimizes adverse effects on respiratory and circulatory functions, 100% of patients after anesthesia fully return to their original state. Using anesthetic method to control TCI target concentration, the patient avoids overdose of anesthetic (drug poisoning). Before anesthesia with this method, the patient will be consulted by the anesthesiologist and clearly explained the benefits of targeted anesthesia as well as the close coordination between the parts to help maximize the benefits. advantages of equipment as well as reasonable adjustment of treatment parameters suitable for each stage of anesthesia. Reduce the rate of nausea and vomiting after recovery The patient will wake up quickly after anesthesia, return to normal activities, make the patient feel comfortable after anesthesia Use the appropriate dose of anesthetic most, save on treatment costs.

3. Use cases for TCI . target concentration controlled anesthesia

Normally, TCI target concentration controlled anesthesia is suitable for almost all surgeries, except for some surgeries that are contraindicated, such as patients with a history of anesthetic allergy, patients with Severe cardiovascular disease, kidney failure, liver failure ... However, TCI intravenous anesthesia is still extremely useful in the following cases:
Endoscopic gastrointestinal surgery Egg suction interventions or interfere with nerves and require early neurological recovery such as spine surgery, brain tumor surgery with high frequency radio waves. , thoracoscopic surgery Outpatient surgery Interventional procedures in obstetrics and gynecology: cervical suture, uterine aspiration curettage, embolization intervention in the treatment of uterine fibroids... High patient Age Patient is at risk of malignant hyperthermia.

4. Notes on anesthetic control of TCI . target concentration

Although the TCI target concentration controlled anesthetic method is an effective anesthetic and leaves few post-anesthetic complications, when using this method, the following issues should be kept in mind:
Do not use TCI in Anesthesia and emergency resuscitation because this technique uses Propofol for direct intravenous anesthesia, which will lower blood pressure, adversely affecting the perfusion pressure to brain tissues and organs. Ensure adequate anesthesia: Use sufficient anesthetic doses to ensure smooth anesthesia and rapid awakening of the patient. Monitor the depth of anesthesia appropriately to avoid unwanted cardiovascular effects due to drug overdose. Prepare adequate analgesics, reflex inhibitors Avoid hemodynamic instability such as using antihypertensive drugs if blood pressure is high, fluid replacement, use of vasopressors if blood pressure is low , use atropine if the pulse is slow... Currently at Vinmec Hai Phong International Hospital in particular, the Vinmec system in general is fully equipped with modern electric syringes specialized for TCI use, with the same team Doctors and nurses are trained to use this method proficiently and safely in cases where this method is indicated. Therefore, customers can feel secure when using medical services at Vinmec.

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