The application research in the close-loop muscle relaxant injection system combined with auditory evoked potentials index for monitoring in elderly patients during general anesthesia / 中华老年医学杂志

ABSTRACT

Objective To observe the clinical efficacy and safety of close-loop muscle relaxant injcction system (CLMRIS) combined with auditory evoked potentials index for monitoring in elderly patients during general anesthesia.Methods A total of 100 patients undergong abdominal operation with ASA Ⅰ-Ⅱ anesthesia in our hospital from February 2012 to October 2012 were selected.Patients were randomly divided into 2 groupsthe traditional group (n=50) and the CLMRIS group (n=50).The traditional group was anaesthetized according to clinical experience,and the CLMRIS group was used with the muscle relaxant guided by the close-loop muscle relaxant injection system.The auditory evoked potential (AEP) index and the life index were observed,and the dose of muscle relaxant,the time of consciousness recovery,dynamic response rate during operation and the adverse reaction were recorded at the time points at entering the operating room,induction of anesthesia,tracheal intubation,incision,into the abdominal,exploration,closing abdomen,skin suture,consciousness recovery,tracheal extubation,out of room (T0-T10).Results The vital signs in all patients were stable.The dynamic response rate during operation was lower in the CLMRIS group than in the traditional group at each time points of T8-T10 (all P＜0.05).There was no increase in mean artery pressure (MAP) and heart rate in groups at the time points of T0-T1,T8-T10 (all P＞0.05).The time of tracheal intubation,tracheal extubation and consciousness recovery were shorter in the CLMRIS group than in the traditional group [(268±30.4) min vs.(172±23.7) min,(14±6.4) min us.(18±7.9) min,(8.8±2.9) min vs.(12.2±4.6) min,respectively,t=3.277,6.341,3.346,all P＜0.05].There were no significant differences in AEP index between groups at the time of T0 (P＞0.05),but at the time of T1,the AEP index was lower in CLMRIS group than in the traditional group (P＜0.05).Conclusions The application of close loop muscle relaxant injection system can improve the safety of general anesthesia in the elderly and reduce the incidence of postoperative residual paralysis.The CLMRIS combined with the auditory evoked potential for monitoring depth of anesthesia can prevent and reduce the incidence of intraoperative awareness,has a strong controllability in general anesthesia with smooth induction,and can reduce the dose of anesthetic drugs to achieve the best anesthetic effect.