To the Editor:-The use of target-controlled infusion of hypnotics and analgesics recently reported (Jain et al. Anesthesiology 1996; 85:522–35) is further evidence of the use of pharmacokinetic model driven drug delivery or computer-assisted continuous infusion (CACI) of anesthetic drugs for use during cardiac surgery. Regrettably, the authors failed to acknowledge previous work in this area, [1–5] which makes their abstract claim “the use of target-controlled infusions of anesthetics for coronary artery graft surgery has not been studied in detail” most problematic. We refer the interested reader to the previously published material cited below.

J.G. Reves, M.D.

Professor and Chairman; Department of Anesthesiology

Robert N. Sladen, M.B., Ch.B.

Associate Professor and Vice Chairman; Department of Anesthesiology

Mark F. Newman, M.D.

Associate Professor and Chief; Division of Cardiac Anesthesiology; Duke University Medical Center; Durham, North Carolina

References 

1.
Alvis JM, Reves JG, Govier AV, Menkhaus PG, Henling CE, Spain JA: Computer assisted continuous infusions of fentanyl during cardiac anesthesia: Comparison with a manual method. Anesthesiology 1985; 63:41-9.
2.
Flezzani P, Alvis MJ, Jacobs JR, Schilling MM, Bai S, Reves JG: Sufentanil disposition during cardiopulmonary bypass. Can J Anaesth 1987; 34:566-9.
3.
Ruff R, Reves JG: Hemodynamic effects of a lorazepam-fentanyl anesthetic induction for coronary artery bypass surgery. J Cardiothorac Anesth 1990; 4:314-7.
4.
Kern FH, Ungerleider RM, Jacobs JR, Boyd JL, Reves JG, Goodman D, Greeley WJ: Computerized continuous infusion of intravenous anesthetic drugs during pediatric cardiac surgery. Anesth Analg 1991; 72:487-92.
5.
Theil DR, Stanley TE, White WD, Goodman DK, Glass PSA, Reves JG: Continuous intravenous anesthesia for cardiac surgery: A comparison of two infusion systems. J Thoracic Cardiovasc Anesth 1993;7:300-6.