Application of close-loop target control infusion system in anesthesia of laparoscopic gastrointestinal surgery

Objective To investigate the feasibility and safety of the close-loop target control infusion system in anesthesia of laparoscopic gastrointestinal. Methods Sixty ASA physical status Ⅰ or Ⅱ patients scheduled for laparoscopic gastrointestinal surgery into two groups (n=30): close-loop target control infusion group (group A) and experienced group (group B). Events in operation were recorded included surgery time, anesthesia time, the consumption of propofol, remifentanil, cisatracurium, extubation time, manually times of narcotic drug and vascular active drug in anesthesia maintenance. The adverse reactions of perioperation included the frequency of intraoperative body dynamic, intraoperative awareness, emergence agitation and delayed awakening were recorded. The postoperative observer's assessment of alertness/sedation(OAA/S) score was recorded. The percentage time narcotrend index (NTI) between 40 to 60 and percentage of time NTI>60 and NTI<40 were also recorded. Results In group A, the extubation time was (7.8±2.4) min, the consumption of propofol and cisatracurium were (13.2±2.8) mg/kg and (0.28±0.06) mg/kg respectively, the number of times of manually controlled narcotic drug delivery was 31. In group B, the extubation time was (12.2±3.6) min, the consumption of propofol and cisatracurium were (15.1±3.1) mg/kg and (0.34±0.10) mg/kg respectively, the number of times of manually delivery narcotic drug was 80. Comparing with group B, they were significantly small in group A (P 60 and NTI<40 of group B were less in group A (P<0.05). The percentage number of time of NTI between 40 and 60 were (81.4±4.8)% in group A and (59.6±8.2)% in group B respectively. Conclusions The close-loop target control infusion system was safe and reliable in anesthesia of laparoscopic gastrointestinal. Comparing with the traditional method, it can reduce the dosage of sedation and muscle relaxants, achieve faster and better quality of the stage of analgesia and reduce the manually number of times of delivering narcotic drug. Key words: Narcotrend monitor; Close-loop; Target control infusion; Anesthesia, general