Target-controlled intravenous anesthesia

Target-controlled infusion (TCI) is a new delivery system for i.v. anaesthetic agents with which the anaesthetist targets a plasma drug concentration to achieve a predetermined effect. With this system, the tedious task of calculating the amount of administered drug required to achieve the target concentration is left in charge of a microprocessor which commands the infusion device. TCI has long been used only by a few research teams, but this year a much wider field opens to this delivery system through marketing of Diprifusor, a TCI system specifically designed for administration of propofol in everyday practice. This article describes the rationale for administering i.v. agents through TCI delivery systems, the pharmacokinetic basis of TCI, the regulations and a broad overview of clinical applications, both recent and yet to come.