Target-controlled Infusion Of Propofol For Constant Rate Infusion Of Fentanyl Intravenous Anesthesia Clinical Applications

Objective: To evaluate the feasibility and the anesthetic trait in patientundergoing target-controlled infusion(TCI) with propofol and constant speedinfusion with fentanyl for total intravenous anesthesia(TIVA). Methods:Thirty-four ASAⅠ～Ⅱ patients scheduled for elective surgery under TCI withpropofol and constant speed infusion with fentanyl for TIVA. Target bloodpropofol concentration was set at 3.0～4.0μg·ml-1 ,anesthesia was inducedwith this propofol concentration and vecuronium 0.1mg·kg-1, fentanyl 3.0 μg·kg-1. In order to maintain anesthesia, the blood propofol concentration was setat 2.0～4.0μg·ml-1 and combined with fentanyl 0.7～2.0μg·kg-1·h-1 byconstant speed infusion. The heart rate(HR), mean artery pressure(MAP), SpO2,bispectral index(BIS), heart rate variability index(HRVI) were recorded atbefore induction, 3 min after induction, intubation, 3 min after intubation,operation, 3 min after start operation, 30 min after start operation, the end ofoperation, recovery and extubation. The consciousness losing time, wakeningtime after stopping propofol infusion , the corresponding blood propofolconcentration at wake and the standardized unit dose of propofol were recordedtoo. Results: MAP decreased significantly after induction(p<0.05),butdecreasing extent only was 6%. BIS was 88.76±8.78,78.56±7.77 at beforeinduction and recovery. During anesthesia, BIS was 44.50±6.18～61.35±3.73.The heart rate variability index was 44.76～49.50 in the course of operation.The mean consciousness losing time was(90.32±47.05)s. The mean wakeningtime was ( 16.74 ± 8.51 ) min and the corresponding blood propofolconcentration was (0.89±0.25)μg·ml-1。The standardized unit dose ofpropofol during induction was (1.47±0.39)mg·kg-1 and it was lower than thedose by single intravenous infusion 2 mg·kg-1. The standardized unit dose ofpropofol during maintain was (5.66±1.52)mg·kg-1·h-1 and it was the lowernumerical value of propofol during maintain. Conclusion: Whentarget-controlled infusion(TCI) with propofol and constant speed infusion with II山西医科大学硕士学位论文fentanyl for total intravenous anesthesia(TIVA), though the consciousness losingtime was longer, the dose of propofol was decreased and hemodynamics wererelatively stable. The wakening time was similar with that ofintravenous-inhalation anesthesia, but the quality of recovery was better thanthat of intravenous-inhalation anesthesia.