Evaluation The Effect Of Closed-Loop Control Of Propofol Anesthesia With Different Dose Of Dexmedetomidine In The Laparoscopic Cholecystectomy

Objective: To evaluate the effect of closed-loop control of propofol with different dose of dexmedetomidine in the laparoscopic cholecystectomy.Methods: Thirty patients subjected to laparoscopic cholecystectomy were all used total intravenous anesthesia,closed-loop control of propofol with plasma target concentration 3ug/ml,and remifentanil 0.2ug/kg·min infused constantly.All patients were randomly divided into three groups(n= 10):group A 、B and C(10 patients respectively).Patients in group A were injected dexmedetomidine with 0.4ug·kg-1·h-1,in group B with 0.5ug·kg-1·h-1 and in group C with dexmedetomidine 0.7ug·kg-1·h-1.The change in BIS,medial arterial pressure(MAP),heart rate(HR),rate pressure product(RPP),peripheral perfusion pressure(Perf)were recorded at base line T0,5 minutes after IV midazolam T1,closed-loop the system immediately T2,before tracheal intubation T3,tracheal intubation immediately T4,CO2 pneumoperitoneum immediately T5,pulling the cholecyst T6,and closing the CO2 pneumoperitoneum T7 and recorded the recovery time,the dosage of propofol and the incidence of adverse reaction: nausea,vomiting,and postoperative delirium.Results: The value of BIS were significantly decreased compared T0 in group(P<0.05),between groups: the time of T6,T7 in group C was significantly decreased than A,B groups,(P<0.05).There was no significant difference in group of HR,while three groups :group C of T6,T7 has significant decreased than group A and B,were 61.9±5.51 bpm and 59.0±5.7bpm(P<0.05).RPP in group A the time of T6,T7 has significant difference than B and C grouos(P<0.05).MAP and Perfusion index had no significant difference in group and among the groups(P>0.05).There were no significantdifference of the dose of propofol,recovery time and the rate of adverse reactions in each groups(P>0.05).Conclusion: closed-loop control of propofol anesthesia with different dose of Dexmedetomidine,(plasma target concentration 3ug/ml),circulation more stable and RPP,perf value display peri operative stress has been effectively controlled.Hemodynamic stability,stress has been effectively controlled from the results of RPP 、 Perfusion index,but compound with dexmedetomidine 0.7ug·kg-1·h-1(C group)the patients had the risk of bradycardia and excessive sedation.