Comparison Different Concentration Of Sufentanil-propofol Target-controlled Infusion With Traditional Total Intravenous Anesthesia In Aged Patients Undergoing Pulmonary Lobectomy

Objective:To observe different concentration of sufentanil-propofol target-controlled infusion(TCI) with traditional total intravenous anesthesia(TIVA) in aged patients undergoing pulmonary lobectomy.And compare the influence of hemodynamics,conciousness and recovery time from anesthesia.Mthods:Sixty aged patients undergoing pulmonary lobectomy were divided into three groups randomly(n=20) low dose sulfetanil TCI group(groupâ… ),high dose sulfetanil TCI group(groupâ…¡) and traditional TIVA(groupâ…¢).The incipient concentration in groupâ… and groupâ…¡were 0.2 ng/ml,0.3 ng/ml respectively.During the course of operation and anesthesia the concentrations in effect compartment of sufentanil and propofol were adjusted according to BIS,MAP and HR.These parameters were recorded when the patients entering the operating room(base), before intratracheal intubation(T₁),the time of double-lumen endobronchial intubation was located(T₂),after intubation three minutes later(T₃),begin operation (T₄),after 15min.(T₅) and extubation(T₆).Result:There were not statistically significance in three groups in BIS(P＞0.05). The dosage of sufentanil in groupâ… was bigger than other two groups(P＜0.05),but there were not statistically significance in groupâ…¡and groupâ…¢(P＞0.05).The dosage of propofol in groupâ… was smaller than in groupâ…¡,but greater than groupâ…¢(P＜0.05).The MAP was degraded at T₄,T₅ in groupâ…¡and groupâ…¢.And the HR was decreased at T₃,T₄ and T₅ in groupâ…¢.However changes of the MAP and the HR still in the normal ranges.BIS was maintained at 45-55 during operation,after 5-6 min of the end of operation patient's eyes can be open.About 2 min later,the endobronchial catheter can be extubated.Conclusion:The results suggest that TCI sufentanil-propofol at 0.2-0.6 ng/ml level by Orchestra workstation,not only ensure sufficient analgesia and adequate depth of anesthesia,but also easily maintain stable hymodynamics.In addition,the traditional TIVA as after manually single dose of sufentanil-propofol then with 1%propofol 50ml plus sufentanil 25μg drip at 30-40 ml/h speed can also achieve the same effect, meanwhile the dosages of sufentanil and propofol were fewer than that of TCI.