The Comparision Of Hemodynamics During Three Different Anesthesias

Objective To investigate the effects of propofol,sevoflurane,or propofol combined with sevoflurane anesthesia in hemodynamics when BIS was maintained at 50 and to provide a more ideal anesthesia method.Method Sixty patients undergoing elective upper abdominal surgery,aged between 35-60 years old,weighting between 50-80kg,ASAⅠorⅡwere choosed. They were randomly allocated to three groups(group S:anesthesia with sevoflurane; group P:anesthesia with propofol; group C:anesthesia with propofol combined with sevoflurane).The patients were premedicated with intramuscular Phenobarbital O.lg and scopolamine 0.3mg. After entering the operating room, opened upper extremity venous channels and infused lactate Ringer's solution. Monitored Electrocardiogram(ECG), direct arterial blood pressure(ABP),pulse oxygen saturation (SpO2) and BIS. After be quiet for 3mins,they were induced with midazolam 0.06mg/kg Fentanyl 3μg/kg,group S induced with sevoflurane and inhaled for maintenance;group P induced with propofol and propofol injected for anesthesia maintenance;group C induced with sevoflurane+TCI propofol(1μg/ml) and sevoflurane+TCI propofol(1μg/ml) for maintenance.When BIS reduced to 75, injected vecuronium 0.12mg/kg.The concentration of sevoflurane and target-controlled propofol plasma concentration were adjust to the changes of BIS value.When BIS reduced to 55 below,tracheal intubation was began.BIS value was maintained at 50±5 during the whole operation.10-15min after tracheal intubation the operation began.l-2min befor surgical incision,each group added fentanyl 2μg/kg.ABP,HR,BIS,inhaled and end-tidal sevoflurane concentration,target plasma concentration of propofol were recorded at intervals(before anesthetic induction,befor intubation, intubation immediately and intubation after 3min,6min,skin incision immediately and after skin incision 5min,exploration).Results There was no significant difference among the three groups before anesthesia induction.After induction,BIS and SBP all reduced of the three groups (P＜0.05),HR had little changes;intubation immediately,HR of group P and S increased higher than group C (P＜0.05),SBP of group P increased significantly (P＜0.05); 6min after intubation to exploration, HR and SBP had little difference among the three groups. When explored, HR and SBP of group P and S increased higher than groupC (P＜0.05).The end-tidal sevoflurane concentration of group C was lower than group S (P＜0.01). Conclusion When BIS was maintaned at 50±5,Anesthesia with sevoflurane+TCI propofol(1μg/ml) can lead to minor variation in hemodynamics, so it will be a good choice for clinical anesthesia.