Clinical Observation On The Application Of Etomidate Effect Chamber Concentration Model In Gynecological Short Surgery

Objective: Aiming at the effect of surgical operation and anesthesia on the cyclic fluctuations of patients during gynecological short surgery,the continuous infusion of etomidate for target-controlled infusion(TCI)effect chamber concentration mode under the guidance of Business information system(BIS)was in the maintenance of anesthesia.Hemodynamics and the incidence of common postoperative complications were observed as well.The effect of the application of this method in anesthesia maintenance of gynecological short surgery was investigated.Methods: Patients aged 18-60 years old who underwent elective short gynecological surgery in Shengjing Hospital of China Medical University were selected,in number of 60,for analysis and were divided into etomidate group(E group,n=30)and propofol group(group P,n=30).Anesthesia induction and maintenance were received by etomidate and propofol TCI respectively,while combining TCI remifentanil hydrochloride.Records of the two groups of patients included systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR)and BIS values before anesthesia induction(T0),immediately after intubation(T1),5 minutes after placing the laryngeal mask airways(T2),one point during surgery(T3),before removing the laryngeal mask airways(T4),and 5 minutes after removing the laryngeal mask airways(T5).Operation time,total amount of remifentanil hydrochloride,time of removing the laryngeal mask airways and postoperative adverse reactions(nausea,vomiting,chills,agitation)were recorded as well.Results: There was no statistically significant difference in basic information,length of operation,intraoperative BIS value,and dosage of remifentanil hydrochloride between the two groups of patients(P>0.05).There was no statistical difference in MAP at time T0 between the two groups of patients,that is,preoperative basal blood pressure(P>0.05).From time T1 to T4,the MAP of the two groups of patients was lower than that of this group at time T0(P<0.05),but at time T2 and T3,The decrease of MAP in group P was significantly greater than that in group E(P<0.05).The statistical analysis of the HR results shows that at T1 and T2,the HR of the two groups of patients was lower than the preoperative basal level,and the difference was statistically significant(P<0.05).However,at T3 and T4,only the HR in group P was lower than the preoperative baseline level(P<0.05),and the HR in group E was not significantly different from the preoperative baseline(P>0.05).Comparison between the two groups showed that there was no statistically significant difference in HR between the two groups in the preoperative basic state(T0)(P>0.05).However,the decrease of MAP in group P was significantly greater than that in group E at T2 and T3,the difference was statistically significant(P<0.05).At other times,there was no statistical difference between the two groups in MAP and HR index groups.The removal time of the laryngeal mask in group E was shorter than that in group P(P<0.05).The rest of the research results included postoperative adverse reactions of the two groups were not statistically different(P>0.05).Conclusion: The continuous infusion of etomidate in the concentration model of the TCI effect chamber under the guidance of BIS can maintain more stable hemodynamic index and more rapid postoperative awakening comparing with propofol,without increasing the incidence of postoperative adverse reactions.It can be used as anesthesia maintenance method for gynecological short surgery.