Effect Of Closed-loop Target Controlled Infusion Of Propofol On Anesthesia Effect And Postoperative Cognitive Function In Patients Undergoing Gastroscopy

Objective:To study the effect of closed-loop target controlled infusion of propofol on anesthesia effect and short-term postoperative cognitive function in patients undergoing gastroscopy or treatment under different bispectral index.Methods:In September 2019,100 patients with painless gastroscopy were selected from the Department of the first hospital of Jilin University.They were divided into two groups according to the method of drawing lots: group D and group S,50 in each group.Propofol was infused by closed-loop target control and plasma target control.The BIS values were 50±5(group D)and 60±5(group S),respectively.Record and compare the data of the two groups before anesthesia,when gastroscope passes through the esophageal entrance,and after diagnosis and treatment.Mean arterial pressure and heart rate,incidence of choking,abnormal respiration,hypoxemia,hiccup,laryngospasm and adverse reactions of hand and foot movements,diagnosis and treatment time,dosage of propofol,wake-up time,out of room time,awareness during operation,nausea and vomiting and 7-day cognitive function scores after operation.Results:1.There was no significant difference between the two groups(P > 0.05)in the mean arterial pressure and heart rate before anesthesia,at the entrance of gastroscope and at the end of diagnosis and treatment.There was significant difference between the two groups in the mean arterial pressure at the entrance of gastroscope and at the end of diagnosis and treatment(P < 0.05).2.Adverse reactions in group D and S: there was no statistical significance in the number of cases of abnormal respiration,hiccup and hand foot movement(P > 0.05);there was statistical significance in the number of cases of choking cough(P < 0.05);there was no hypoxemia and laryngospasm in group D and S during operation.3.There was no significant difference in diagnosis and treatment time,propofol dosage,recovery time and out of room time between the two groups(P > 0.05).There was significant difference between two groups in the number of additional cases of propofol(P < 0.05).There was no intraoperative awareness,nausea and vomiting in both groups.4.There was no significant difference in MMSE score between the two groups(P > 0.05).Conclusion:In this experiment,under the feedback of different bispectral index of EEG,propofol infusion with closed-loop target control in the BIS value of 50 ± 5 group had better anesthesia effect on patients undergoing gastroscopy or treatment in outpatient department,less adverse reactions during operation and higher satisfaction of endoscopists.However,the patients in the two groups had the same satisfaction with anesthesia and cognitive function 7 days after operation.Through the study of closed-loop target controlled infusion in painless gastroscopy diagnosis and treatment of outpatients without previous experiments,it is found that the closed-loop target controlled infusion system can not only reduce the adverse reactions of patients,but also reduce the workload and work intensity of anesthesiologists,and provide reference for future clinical work.