The clinical application of target-controlled infusion propofol guided by the bispectral index for anesthetic induction in the elderly patients

Objective To observe the different effects on BIS guided propofol TCI and artificial method for induction of anesthesia in elder patients.Methods Forty-five elderly patients undergoing radical gastrectomy for stomach cancer were randomly allocated into three groups.In group Ⅰ,BIS was definited as control target;in group Ⅱ and Ⅲ,clinical hemodynamic pramater as control target.In group Ⅰ and Ⅱ,all patients were induced with propofol TCI.In group Ⅲ,propofol was pumped at constant rate.HR,SBP,DBP and BIS were recorded in ante-induction(T0),loss of consciousness(T1),intubation(T2),at 1 min(T3),3 min(T4) and 5 min(T5) after intubation.Blood glucose,plasma cortisol,norepinephrine epinephrine,concentration were measured at same time points.Results SBP,DBP and HR at T1,T2 were lower than T0(P0.05)in three groups;at T3 SBP,DBP in group Ⅰ,Ⅱ were lower than that in group Ⅲ(P0.05);In group Ⅲ,HR were higher than that in group Ⅱ at T3.(P0.05).Cor concentration was lower at T2 than T0(P0.05) in three groups;in group Ⅱ,Ⅲ,cor concentration at T3,T4 were higher than T2;(P0.05);In three groups NE,E plasma concentration were higher at T3 than T0(P0.05),and the concentration of NE,E at T5 were lower than those at T3(P0.05).Conclusion Propofol TCI guided by the BIS in anesthesia induction can attenuate the stress reaction caused by tracheal intubation and guarantee the equability of haemodynamics.