The Impact Of BIS And AAI To Control The Depth Of Anesthesia On The Stress Response In The Total Intravenous Anesthesia

Objective To evaluate the impact of BIS and AAI to control the depth of anesthesia on the stress response in the Total intravenous anesthesia,and to compare it with the usage of MAP and HR.Methods Forty ASAⅠorⅡadult patients undergoing gastrectomy surgery using total intravenous anesthesia were randomly assigned to the control group (C) or the monitoring group (M).After the infusion of midazolam 0.05mg.kg-1 ,TCI propofol 2.0ug.ml-1 and remifentanil 2.0 ng.ml-1 ,laryngoscopy and intubation were facilitated with intravenous rocuronium 0.6～1.0mg.kg-1 .Control group:To maintain the depth of anesthesia according to the traditional hemodynamic parameters to adjust anesthetic dosage to maintain blood pressure and heart rate fluctuating in their respective basic value of±20%. Monitoring Group: According to the BIS and AAI values to adjust anesthetic dosage to maintain the AAI value in the range of 15～30 and BIS value in the range of 40～55.In the control group the anesthesiologists were not permitted to observe the BIS or AAI values during the intraoperative period.MAP,HR,SpO2,the BIS indices and AAI indices and the values of blood glucose and cortisol were recorded on several designated points.The OAA/S scale score and if the intraoperative awareness happened or not were assessed after surgery. Results The MAP and HR of the control group had risen at the point of surgical incision(P<0.05).The BIS and AAI indices of control group were higher than the indices of monitoring group during the operation(P<0.05).The values of blood glucose and cortisol of control group were all higher than the values of monitoring group during the operation(P<0.05). The recovery time of monitoring group were short than the time of control group. Intraoperative awareness had happened in one patient of control group.Conclusions To control the depth of anesthesia with the BIS and AAI devices could shorten the recovery time, avoid intraoperative awareness, reduce the excessive stress response over the body and improve the quality of anesthesia.