Target-controlled step-by-step increasement infusion versus manual-controlled infusion of propofol for gastroscopy
- VernacularTitle:胃镜检查中泵输注与手控输注异丙酚麻醉效果的比较
- Author:
Rong DONG
;
Yan LUO
;
Buwei YU
- Publication Type:Journal Article
- Keywords:
Propofol;
Gastroscopy;
Pump infusion;
Manual controlled infusion
- From:
Chinese Journal of Digestion
2001;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of target-controlled infusion (TCI) and manual controlled infusion (MCI) of propofol in out-patients undergoing gastroscopy with the sedative depth monitoring by bispectral index (BIS).Methods Forty-eight patients with physical status Ⅰ-Ⅱ scheduled for an elective gastroscopy under general anesthesia were enrolled in this study. All patients were randomly divided into two groups, group T (n=24) and group M (n=24). Before induction, all patients were received a single dose of fentanyl (1 ?g/kg) intravenously. With the monitoring of BIS, the gastroscope was inserted in by the time of BIS value less than 60. Patients in group T received a propofol infusion with the initial plasma concentration of 1 ?g/ml and then the dose was titrated upward by 0.5 ?g/ml each time till the BIS values was less than 60 and then propofol was maintained at a concentration of 2-3 ?g/ml. In the group M, propofol was infused at a rate of 4 g/h until the BIS was less than 60 and then propofol was administrated at a rate of 4-6 mg?h -1?kg -1. During the period of gastroscopy, the sedation depth was maintained by BIS value of 40 to 60. The infusion was stopped by the end of biopsy in both groups. The time from induction to put in the endoscopy, the examination maintenance and the duration of anesthesia, the induction and total amounts of propofol infused were recorded and the average infusion rate was calculated. Results The induction time was significantly shorter in group T than in group M. The duration of examination, time from the induction to opening the eyes and time from induction to the orientation were not significantly different between two groups. Propofol consumption for induction and maintenance was much higher in group M than in group T. The average infusion rate was not significantly different in both groups. The BIS values were almost same at the beginning of gastroscopy and at opening the eyes. The plasma concentration and effect-site concentration were (4.25 ?0.94) ?g/ml and (1.78?0.66)?g/ml at the time of beginning of gastroscopy; while being (1.34?0.39) ?g/ml, ( 1.77?0.40) ?g/ml at the time of opening the eyes. There were 3 cases in group T and 7 cases in group M had sidereactions during the gastroscopy, respectively, but all were mild. Conclusions BIS could be a good sedative depth monitor in total intravenous anesthesia in out-patients gastroscopy. Target-controlled infusion system can help us to get accurate depth of anesthesia quickly and stably, and decrease the consumption of propofol and side effects as well.
