THE INFLUENCE OF TWO MODALITIES OF INTRASPINAL ANESTHESIA ON BIS GUIDED SEDATION WITH PROPOFOL

Objective To compare the effect between two types of intraspinal anesthesia on Bispectral guided sedation with propofol.Methods Sixty patients scheduled for selective gynecological abdominal surgery were randomized to combined spinal-epidural anesthesia sedation group(group A) and epidural anesthesia sedation group(group B).The analgesia plane in patients in two groups was controlled at between T6 and T8.The TCI of propofol was started at a target plasma concentration of1.2 mg/L,followed by increments 0.2 mg/L at 30 seconds intervals until the BIS value reaching 70.The BIS was maintained at between 65 and 75 at surgery.The propofol effect-site concentrations at incision,abdominal exploration,traction of uterus,douching of abdominal cavity and at the end of surgery were compared between the two groups.The initial dose and total dose of propofol,operation time,sedation time,the use of ephedrine and atropine,the volume of infusion and blood loss were compared between the twp groups.Results Compared with group B,the propofol effect-site concentrations in each point of time of group A were significantly lowered(t=2.201-2.920,P0.05);the initial and total dose of propofol decreased(t=2.473,2.639;P0.05);the usage of ephedrine increased(χ2=9.130,P0.05).There were no significant differences between the two groups in respect of operation time,duration of sedation,volume of transfusion,blood loss at surgery and usage of atropine(P0.05).Conclusion Compared with epidural anesthesia,the combined spinal-epidural may decrease the effect-site concentration of BIS guided sedation with propofol and its dosage,showing much stronger in sedation.