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| The application of target controlled infusion with Propofol by Marsh model versus Schnider model during gynecological laparoscopic surgery |
| WEI Hong FENG Jiehua Tu Hankun LI Chaoyang▲ WU Dong LUO Xiaoming |
| Department of Anesthesiology, Shenzhen Nanshan People′s Hospital, Guangdong Province, Shenzhen 518052, China |
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Abstract Objective To evaluate the applicability of target controlled infusion (TCI) with Propofol by March model and Schnider model during gynecological laparoscopic surgery. Methods One hundred unpremedicated patients (18 to 55 years, ASA Ⅰor Ⅱ ) undergoing gynecologic laparoscopy in Shenzhen Nanshan People′s Hospital from Janurary to June 2016 were randomized into two groups (n = 25 each ) using a random number table ：group M and group S. Propofol was administered by TCI, with respectively March model and Schnider model in two groups, and combined with Remifentanil. The age, weight, anesthetic time, operative time, time for loss of consciousness, the corresponding amount of Propofol and effect site concentration of Propofol (Ce) at loss of consciousness (LOC) and Ce at recovery of consciousness(ROC), time from discontinuation to analepsia, time from discontinuation to extubation, heart rate (HR), mean arterial blood pressure (MAP) and bispectral index (BIS) were monitored and recorded before induction (T0), loss of consciousness (T1), before intubating (T2), after intubating (T3), skin incision (T4), consciousness (T5), extubation (T6), the total amount and unit time amount of Propofol. Intraoperative awareness was evaluated at 24 hours postoperation. Results There was no significant different in the time of lose consciousness and the amount of Propofol between group M and S (P > 0.05). but The total amount and unit time amount of Propofol in group S were more than that in group M (P < 0.05). The time from discontinuation to analepsia and the time from discontinuation to extubation of group S were both longer than group M (P < 0.05). Compared with T0, there were no significant different in HR, MAP at T1, T2, T3, T4, T5 and T6 in both groups(P > 0.05). Compared with group M, there were no significant different in HR, MAP at T0-6 in group S(P > 0.05). There were no significant different in BIS at T0, T2, T3 between the two groups, but at T1, T4, T5, T6 BIS in group S were lower than in group M (P < 0.05). No intraoperative awareness happended. In group M Ce at LOC was positively correlated to Ce at ROC (P < 0.05). Conclusion TCI with Propofol during gynecological laparoscopic surgery, Marsh model was better than Schnider model.
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