The Study Of Take MAC-awake Sevoflurane Inhalational Anesthesia Effect On The Quality Of Target Controlled Infusion Of Total Intravenous Anesthesia In Gynecologic Laparoscopic Surgery

Objective:We aimed to observe inhalate MAC-awake sevoflurane effect on the total intravenous anesthesia（TIVA）using propofol-remifentanil with target controlled infusion（TCI）:whether the respiratory system and circulatory system will be more stable,and won’t be increase the incidence of adverse reactions.To estimate the importance of inhalate MAC-awake sevoflurane effect on the quality of TIVA using propofol-remifentanil TCI.Methods:Forty gynecologic laparoscopic operation patients were divided into two groups:group P and group S,which divided by random digits table method with 20 cases each.All patients’ induction were implemented by intravenous injection: midazolam 0.03mg/kg,sufentanil 0.5μ g/kg,etomodate 0.2mg/kg,cis-atracurium 0.2mg/kg.The group P using TIVA,the group S using intravenious-inhalation combined anesthesia.Mean arterial pressure（Map）,heart rate（HR）,blood oxygen saturation（SpO2）,end-tidal carbon dioxide（ETCO2）,peak airway pressure（Peak）,bispectral analysis（BIS）,CT were recorded separated at different time points as follows:after entering the operating room 10min（T₀）,the time begain to operation（T₁）,15 min after pneumoperitoneum（T₂）,30 min after pneumoperitoneum（T₃）,the moment of extubation（T₄）.Recorded the complication occurred after operation 2h and the intraoperation awareness within 24 h.Results:The operation time,anesthesia time,incidence of adverse reaction between the two groups were not significantly different（P>0.05）.Compared with at T₁,Map,HR and Peak were significantly increased in both groups at T₂,T₃（P<0.05）.Compared with at T₃,HR in group S was significantly lower than in group P（P<0.05）.Map and Peak in group S was significantly lower than in group P at T₁,T₂（P<0.05）.Conclusions: TIVA using propofol-remifentanil with TCI could be safely used in gynecologic laparoscopic surgery.The respiratory system and circulatory system will be stable.Inhalate of MAC-awake sevoflurane lead to the circulatory system be more stable,and reduce the airway pressure,and won’t be increase the incidence of adverse reactions.Inhalate of MAC-awake sevoflurane is worthy to be popularized in laparoscopic surgery.