EFFECT OF CLOSED-LOOP TARGET-CONTROLLED INFUSION OF PROPOFOL GUIDED BY BISPECTRAL INDEX ON HAEMODYNAMICS AND BIS VALUE IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY

YANBIN BAI, KAI CHEN

Department of Anaesthesiology, Yanan University Affiliated Hospital, 716000

Objective: To explore the effect of closed-loop target-controlled infusion (CLTCI) of propofol guided by bispectral index (BIS) on haemodynamics and BIS value in gastrointestinal cancer patients undergoing surgery.

Methods: A total of 213 cancer patients requiring surgery, who were admitted to the Department of Gastrointestinal Surgery of our hospital from January 2016 to November 2017, were recruited into the study and randomly assigned to a control group (n=106) and an experimental group (n=107). Propofol and remifentanil were infused by open-loop target- controlled method in the control group, while the closed-loop target-controlled method was used in the experimental group during surgery. Haemodynamic, BIS value and intraoperative anaesthetic drug dosage, regulation frequency and blood drug concentration as well as postoperative recovery of the two groups were compared.

Results: Haemodynamic indexes, such as mean arterial pressure (MAP), heart rate (HR) and cardiac output index (CI), and BIS values were much lower in the two groups after anaesthesia compared to before anaesthesia (P<0.05). Furthermore, changes in hae- modynamics and BIS values during surgery were much smaller in the experimental group than those in the control group (P<0.05). Additionally, the regulation frequency of propofol and remifentanil during surgery was much greater in the experimental group than in the control group, but intraoperative drug dosage and blood drug concentration and postoperative recovery time of consciousness and spontaneous respiration were much less in the experimental group than in the control group (P<0.05). However, there was no statistical difference in intraoperative awareness, nausea and vomiting, delirium and cardiovascular events within 24 hours after anaesthesia between the two groups (P>0.05).

Conclusions: The BIS CLTCI system can greatly weaken the fluctuation of haemodynamics of gastrointestinal cancer patients undergoing surgery during propofol anaesthesia, keep BIS values in a stable and reasonable range, increase the frequency of drug con- trolled during surgery, reduce the dosage and blood drug concentration of propofol and remifentanil and shorten the recovery time of consciousness and spontaneous respiration after surgery with good efficacy and safety.