Effects of epidural target controlled administration of combined ropivacaine and propofol on blood pressure and heart rate in patients of different age undergoing thoracotomy / 解放军医学杂志

ABSTRACT

Objective To evaluate the effects of epidural anesthesia by target controlled introduction (TCI) of 0.375% ropivacaine (Ropi) combined with propofol on the blood pressure (BP) and heart rate (HR) of the patients in different age during thoracotomy. Methods Seventy five ASA Ⅱ-Ⅲ patients undergoing elective resection of esophageal carcinoma were divided into 3 groups according to their age (25 each) groupⅠ (aged 40～59), group Ⅱ (aged 60～74) and group Ⅲ (aged ≥75). An epidural catheter was inserted at the T6～T8 interspace in all patients before induction, and then 5ml of 1% lidocaine was given to all the patients. For each patient, 6 ml of 0.375% Ropi was given epidurally. Anesthesia was induced with propofol TCI 3?g/ml, fentanyl 3?g/kg and atracurium 0.6mg/kg. Tracheal incubation was performed when bispectrum index (BIS) value was less than 50. The patients were mechanically ventilated. Anesthesia was maintained with propofol TCI and epidural anesthesia of 0.375% Ropi at 6ml/h. Propofol was subsequently adjusted to maintain BIS at 50～55 during operation. The concentrations of propofol TCI, mean arterial pressure (MAP), HR, and the amount of ephedrine were continuously monitored during anesthesia. Results MAP in group Ⅱ and Ⅲ was lower than that in groupⅠ (P0.05). The amount of ephedrine used in group Ⅱ and Ⅲ was higher than that in group Ⅰ (P