Effect Of Different BIS Values On Tissue Oxygenation In Elderly Patients Undergoing Gastrointestinal Surgery With The Monitoring Of SVV

Objectives The objective of this study was to investigate the effects of different BIS values on perioperative blood oxygenation in elderly patients with gastrointestinal by compare the changes of Scv O2 and ABL in two kinds of anesthesia depth models,which were deep anesthesia and shallow anesthesia.Methods 60 patients with gastrointestinal cancer underwent gastrointestinal cancer surgery from November 2015 to April 2016 in the North China University of Science and Technology,ASA grade Ⅱ~Ⅲ were randomly divided into two groups: deep anesthesia group D(BIS40 ~ 49)30 people and shallow anesthesia group L(BIS50 ~ 59)30 people.All subjects were treated with anesthesia and the surgeon was the same group of surgeons.All of the monitoring indexes SVV of the Flo Trac / Vigileo cardiac output monitoring system were combined with CVP for target management.The SBP,DBP,HR,SPO2 and PETCO2 were monitored and recorded in 5min before induction of anesthesia(T0),immediately after intubation(T1),the beginning of surgery(T2),one hour after surgery(T3),two hours after surgery(T4),at the end of operation(T5);And the CO,CI,SVV,DO2 of each time point were recorded by Vigileo.In addition,we obtained a blood sample for evaluation of central venous oxygen saturation(Scv O2)and arterial blood lactate(ABL)from each patient two milliliter.All samples were obtained immediately after intubation(T1),one hour after surgery(T3),at the end of operation(T5).Results There was no difference observed in age,gender,BMI,ASA,type of diseases and surgery between these two groups(P>0.05).No significant difference in MAP,HR and Sp O2 between the two groups(P > 0.05).The Scv O2 was significant difference between the two groups and in eath group(P < 0.01),the difference between the two groups have statistical significance;no statistical significance ABL the difference between the two groups.There was no significant difference in Ca O2,Cjv O2 and ERO2 between the two groups at different time points(P>0.05).There was no significant difference between the two groups in the time of operation,the amount of blood loss during operation,the total amount of urine in the operation,the total amount of crystalloid infusion and the infusion of red blood cells(P>0.05).Compared with L group,the dosage of propofol in group D was significantly increased,the difference between the two groups was statistically significant(P<0.05);Compared with the L group,the recovery time and extubation time of the two groups were significantly longer than that of the D group,the difference was statistically significant(P < 0.05).There was no significant difference in postoperative anesthesia related complications between the two groups(P<0.05).Postoperative followup of two patients showed no intraoperative awareness.Conclusions 1 Under the same surgical effect,the BIS value was maintained at 50~59 in elderly patients with gastrointestinal surgery,which improved microcirculation and tissue oxygen supply better.2 Under the same operation effect,the BIS value is maintained at50~59,which can obviously shorten the time of recovery and extubation,reduce the dosage of narcotic drugs,reduce the financial burden of patients,and make anesthesia drugs more scientific.