Total intravenous anaesthesia in neonatal surgery: a case series using the Eleveld model


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Chan, W. K., Mohtar, S., & Teo, S. C. (2023). Total intravenous anaesthesia in neonatal surgery: a case series using the Eleveld model. Malaysian Journal of Anaesthesiology, 2(1), 82–90.

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Copyright (c) 2023 Weng Ken Chan, Sanah Mohtar, Shu Ching Teo


Eleveld model; neonatal surgery; target-controlled infusion; total intravenous anaesthesia; tracheoesophageal fistula repair


The practice of total intravenous anaesthesia (TIVA) target-controlled infusion of propofol (TCI-propofol) during neonatal surgery was limited by the lack of an appropriate pharmacokinetic-pharmacodynamic model and safety concerns. This is due to the physiological differences between the adult and neonate populations as well as inter-individual pharmacodynamic variation. Eleveld is the latest propofol pharmacokinetic model commercially available and the only model with the neonatal population in its algorithm design. We present a case series of neonates that underwent neonatal surgery under TIVA TCI-propofol utilising the Eleveld pharmacokinetic model. There was no observable clinically significant hypotension intraoperatively. Careful titration of TCI-propofol was necessary for timely emergence and maintaining haemodynamic stability. All neonates were extubated well postoperatively and recovered uneventfully. These demonstrated good and desirable anaesthetic effects using TCI-propofol without undesirable short-term side effects, especially clinically significant hypotension.


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