The Comparative Study Of General Anesthesia Combined With Epidural Anesthesia With General Anesthesia Under The BIS Monitoring

Objective To compare epidural anesthesia combined with general anesthesia with general anesthesia on the dose of propofol, sufentanil ,removing intratracheal cannula time and the tendency of hemodynamic changes under the BIS monitoring .Methods Fourty ASA I-II patients scheduled to undergoing epigastric surgery were assigned to completely total intravenous anesthesia (GA, n=20) or receive epidural anesthesia combined with total intravenous anesthesia(GEA, n=20). In group GA, patients receive midazolam 0.05mg/kg, sufentanil 0.4ug/kg and vecuronium 0.1mg/kg, applying ladder-type target-controlled infusion (TCI) of propofol-induced to achieve BIS between 40~50, and endotracheal intubation followed . Anesthesia is maintained with intermittent injection of vecuronium , titrating of sufentanil 0.2～0.4μg/kg/h,the TCI of propofol to maintain BIS between 40~60. PCA is used in this group postoperatively . Epidural block is performed in group GEA firstly, after block plane comes to the needed level, induction and endotracheal intubation is performed after that. PCEA is used in group GEA postoperatively. Recording HR,BP,BIS at different time, the extubation time, the total operating time, the total dose of propofol and sufentanil ,the occurrence of the perioperative awareness, and the times of using vasoactive drugs .Results No statistical differences were found on the demographic date and operative details between two groups (P <0.05). There were significant decrease in SBP,HR and BIS were found between two groups (P <0.05). The ladder-type target-controlled infusion of propofol-induced of group GEA was lower than in group GA (P <0.05). In group GEA, significant reduction were also observed in total dosage of propofol and sufentanil(P <0.05). The extubation time was less in group GEA than in group GA (P <0.05). None intraoperative known occurred during operation. The tendency of hemodynamic changes was similar to that of BIS.Conclusion Under the BIS monitoring, epidural anesthesia combined with general anesthesia in patients can reduce the requirement of propofol and sufentanil , removing intratracheal cannula earlier and less complication. The tendency of hemodynamic changes was more stable during operation than that of group GA.