Application of epidural anesthesia combined with propofol sedation performed by targeted concentration infusion in patients undergoing total pelvic floor reconstruction surgery / 重庆医学

ABSTRACT

Objective To evaluate the feasibility of combining the sedation performed by propofol targeted concentration in-fusion with epidural anesthesia in patients undergoing total pelvic floor reconstruction.Methods A total of 80 eligible patients were recruited and were assigned randomly into the study group(n=40)and the control group(n=40).All patients in both groups were administered epidural anesthesia with the puncture and catheter placing in the space between the 2nd-3rd lumbar vertebras.After the epidural anesthesia,patients in the study group were administered propofol by targeted concentration infusion (TCI)system. The plasma concentration of propofol was modulated to obtain the BIS maintaining between 65-80,and the OAA/S maintaining at 3 scores.The propofol was continuously infused until closing the incision.Values of HR,MAP at different time points in the opera-tion were recorded,and the plasma concentrations of propofol,the incidences of adverse events were recorded.Results The HR and MAP of patients in the study group decreased at T1 (given the anesthetic),T2 (the beginning of the operation),T3 (the beginning of the operation),compared with those at T0 (before the anesthetic)and T4 (30 min after the operation)(P 0.05).BIS of study group was (73.3 ±4.8)-(76.1 ±3.4),and the plasma concentrations of propofol was(1.32 ± 0.29 )μg/mL - (1.52 ± 0.26 )μg/mL.Conclusion The combination of propofol sedation performed by TCI and epidural anesthesia could be safely and effectively used in patients undergoing total pelvic floor reconstruc-tion.