The Application Of Closed-loop Target Controlled Infusion Of Propofol In Elderly Patients With General Anesthesia

Objective To investigate the effect and safety of closed-loop target controlled infusion of propofol in elderly patients with general anesthesia.Methods This study is a prospective, randomized, parallel controlled study. We select 60 ASA I ~ II urological patients randomly aged 60 years of age or above. These patients are divided into three groups, each group of 20 cases: group A, closed-loop target controlled infusion of propofol; group B, open-loop target controlled infusion of propofol; group C, artificial continuous infusion of propofol. The target values of bispectral index(BIS) during anesthesia are 50 ± 5 for the three groups. Respectively we record the mean arterial pressure(MAP), heart rate(HR), the bispectral index(BIS) at the time of induction(T0), trachea cannula(T1), 5 minites after trachea cannula(T2), starting operation(T3),5 minites after starting operation(T4), end of operation(T5), tube drawing(T6),and the total dosage of propofol during operation,intraoperative hypertension, intraoperative hypotension, the number of pump adjustment, anesthesia time, operation time, extubation time, restlessness after tracheal extubation, postoperative nausea and vomiting, and intraoperative awareness. Then we calculate the dosage of propofol in unit anesthesia time(the total dosage of propofol/ anesthesia time)and the dosage of propofol in unit operation time(the total dosage of propofol/ operation time).Results The dosage of propofol in unit anesthesia time and unit operation time in AC two groups are significantly less than that in B group(P<0.01). BC two groups of patients with intraoperative hypotension are more than A group(P<0.05). In T2 time, BIS index of A group is significantly lower than C group(P<0.01), closer to the target value. In T3 time, BIS indices of the A B two groups are significantly lower than that of C group(P<0.01), closer to the target value. In T4 time, BIS indices of the A B two groups are lower than that of C group(P<0.05). In T5 time, MAP of A group is significantly higher than that of group B(P<0.01), closer to the basic blood pressure. In the 3 groups, there are all no intraoperative awareness. The number of pump adjustment in A group is significantly less than BC two groups(P<0.01).Conclusion Target controlled infusion of propofol is more beneficial to maintain the depth of anesthesia compared with artificial continuous infusion, and closed-loop target controlled infusion can significantly reduce the dosage of propofol compared with open-loop target controlled infusion. Closed-loop target control infusion can reduce the incidence of intraoperative hypotension, to make the operation more stable. And it can reduce the manual operation, to make the anesthesia easy.