The Study Of Median Effective Plasma Target Controlled Infusion Of Propofol And Hemodynamic Changes Durning The Inhalation Of Mac-awake Sevoflurane

Objective:to calculate the median effective plasma target controlled infusion(Cp50)of propofol and compare the hemodynamic changes between inhalation-intravenous balanced anesthesia and total intravenous anesthesia(TIVA)based on the bispectral(BIS)index durning gynecologic abdominal surgery.Method:thirty-three gynecologic patients of American society of anesthesiologist(ASA)physical status ?-?,aged 18-65yrs,body mass index 18-32(kg/cm2)were randomly divided into two groups:experimental group(group S,17 cases)and Controlled group(group P,16 cases).Anesthesia induction:both groups inject with TCI sufentanil 0.5ng/ml,i.v.etomidate 0.2 mg/kg,we do not inject cis-atrucurim 0.2 mg/kg until the patients loss of consciousness.Anesthesia maintenance:Group P was taking Mac-awake(0.33%)sevoflurane in 2 L oxygen until the end of the surgery.Both group target controlled infusion propofol at different plasma concentration and sufentanil(0.2 ng/ml).The target plasma concentration of propofol in group P and S was initially set at 2.0?pg/ml,and adjusted by the sequential up-and-down method,based on BIS index.Anesthisa emergence:when began to close the abdominal,sevoflurane and sufentanil were stopped.At the end of the surgery,propofol was stopped.The Cp50 of propofol and its 95%confidence interval(CI)were calculated.Durning the surgery,fifteen points(T0…Tn+1)of mean atrial pressure(MAP),bispectral index(BIS),heart rate(HR),blood oxygen saturation(SpO2)and end-tidal carbon dioxide(EtCO2)were recorded.Results:The median effective plasma target concentration of propofol in group S and group P was 1.61?g/ml,(95%CI 1.57-1.66?g/ml)and 2.17?g/ml,(95%CI 2.07-2.29 ?g/ml).Group S has a lower plasma target concentration than group P.And both groups can keep the hemodynamic stable.Conclusions:The median effective plasma target concentration of propofol in group S and group P was 1.61?g/ml,(95%CI 1.57-1.66?g/ml)and 2.17?g/ml(95%CI 2.07-2.29?g/ml).Both groups can keep the hemodynamic stable.