Efficacy of closed-loop infusion of propofol for surgery on body surface in preschool and school-age pediatric patients

Objective To evaluate the efficacy of closed-loop infusion of propofol for surgery on the body surface in preschool and school-age pediatric patients. Methods American Society of Anesthesiologists physical status Ⅰ pediatric patients of both sexes, undergoing elective surgery on the body surface, were included in the study.One hundred twenty-four preschool pediatric patients (aged 3-6 yr) were divided into 2 groups (n=62 each) using a random number table: closed-loop group (CPRE group) and open-loop group (OPRE group). Thirty-eight school-age pediatric patients (aged 7-12 yr) were divided into 2 groups (n=19 each) using a random number table: closed-loop group (CSTU group) and open-loop group (OSTU group). The target bispectral index (BIS) value was set at 50 during maintenance of anesthesia.Propofol was delivered using closed-loop anesthesia delivery system, and the target plasma concentration of propofol was automatically regulated in CPRE and CSTU groups.Propofol was given using open-loop anesthesia delivery system, and the target plasma concentration of propofol was manually regulated in OPRE and OSTU groups.The adequate anesthesia time ratio (BIS40-60%) and global score (GS) of the delivery system were recorded during maintenance of anesthesia.The consumption of propofol, frequency of regulation and mean BIS value were recorded.The delivery system-related complications were recorded during the perioperative period. Results Compared with group OPRE, the consumption of propofol, GS and mean BIS value were significantly decreased, BIS40-60% was increased (P 0.05). Compared with group OSTU, GS was significantly decreased, BIS40-60% was increased (P 0.05). Compared with group CPRE, the consumption of propofol and GS were significantly decreased, BIS40-60% was increased (P 0.05). One pediatric patient in group CSTU developed airway spasm, and no severe complications were found in the other pediatric patients. Conclusion For surgery on the body surface in preschool and school-age pediatric patients, closed-loop infusion of propofol is safe and effective, the stability and precision of anesthesia is superior to that of open-loop anesthesia delivery system, and it provides better efficacy in school-age pediatric patients than in preschool pediatric patients. Key words: Propofol; Drug delivery systems; Child