Clinical study on the sedation depth and the best dosage of propofol and remifentanil in anesthesia maintenance of patients underwent abdominal surgery

Abstract

Objective To study the sedation depth and the best dosage of propofol and remifentanil in anesthesia maintenance of patients underwent abdominal surgery. Methods The main research subjects were selected from March 2016 to March 2015 for abdominal surgery (operation time within 4 hours). After evaluation, 86 patients were selected for the study. The patients were randomly divided into three groups. Each group was given different depth of anesthesia, 30<BIS value≤40 in group Ⅰ, 40<BIS value≤50 in group Ⅱ, 50<BIS value≤60 in group Ⅲ, respectively. PSI scores were recorded for the maintenance of anesthesia in each group. Monitoring of surgical patients with heart rate (HR), mean arterial pressure (map), pulse oxygen saturation (SpO2); the dosage of drugs were recorded, bradycardia, hypotension, nausea and vomiting, low blood disease, restlessness, recalling the chills, postoperative pain, nausea, vomiting and other adverse conditions occurred and the patient’s satisfaction was recorded. Results During anesthesia, the dosages of propofol and remifentanil in the three groups were (365.1±55.3) mg and (330.7±60.0) g, (401.8±72.5) mg and (378.9±106.7) g, (468.1±91.7) mg and (428.9±121.2) g, respectively. The PSI score of group Ⅰ was slightly higher than that of group Ⅱ, and the level of anesthesia was lower. The PSI score of group Ⅲ was the lowest, the level of anesthesia was higher, which was not conducive to postoperative recovery of patients. The incidences of bradycardia, nausea and vomiting, hypoxemia were significantly lower in group Ⅱ than those in the group Ⅰ, group Ⅲ. The incidences of bradycardia, hypotension, nausea and vomiting, hypoxemia, restlessness and other adverse reactions in group Ⅲ were the highest. The satisfaction degree was 90.78%, 97.50%, 83.50%, respectively. Conclusions Appropriate depth of anesthesia has little effect on the respiratory system, oxygenation is good, the circulatory system is relatively stable, the stress reaction is mild, without significant side effects, it is worthy of clinical application. Key words: Abdominal operation patients; Patient state index; Anesthesia maintenance; Propofol; Remifentanil