Effects Of Precision Anesthesia Management On Postoperative Recovery Of Patients Undergoing Laparoscopic Pancreaticoduodenectomy

Objective:The purpose of this study was to compare the precision anesthesia management with traditional anesthesia management of goal-directed fluid therapy(GDFT)combined with closed-loop target anesthesia delivery system(CLADS)in laparoscopic pancreatoduodenectomy.To investigate the effects of accurate anesthesia management on postoperative recovery of patients undergoing laparoscopic pancreatoduodenectomy.Methods:60 cases of patients undergoing elective laparoscopic pancreaticoduodenectomy,male or female,aged from 45 to 65 years,BMI18-29kg/m~2,ASA II-III,were randomly divided into two groups.Precision anesthesia group P group and traditional anesthesia group T group,30 cases in each group.All included operations were performed by the same group of surgeons.Group P was connected with propofol closed loop target control pump and muscle release monitor,and continuous monitoring of SVV,SVI,CI and CVP was performed by Flotrac/Vigileo system after local anesthesia and central venipuncture.Both anesthesia induction and anesthesia maintenance were performed with propofol closed-loop target-controlled infusion system and close-loop muscle relaxation infusion system.GDFT was adopted in liquid management to control SVV?13.Group T was anesthetized by traditional methods.The radial artery and central vein were punctured with local anesthesia.The infusion of propofol was performed by routine infusion.Intermittent intravenous administration of cisatracurium to maintain muscle relaxation.The dosage of propofol and cisatracurium during operation,liquid intake and output volume,the value of arterial blood gas lactate,postoperative recovery time,extubation time,postoperative exhaust time,fluid diet time,sitting up after operation and moving out of bed were recorded respectively.Theincidenceofpostoperativecomplications,secondarysurgery,postoperative hospital stay and so on.Results:Compared with group T,the total fluid infusion volume was higher,while the lactate was lower in group P.The recovery time,extubation time and orientation recovery time were shortened.And the time to first flatus,time of influent water and time of fluid diet were shortened in group P(P<0.05).The lower incidence of pulmonary infection and shorter postoperative hospital stay were observed in group P(P<0.05).There were no significant differences in total amount of propofol and cisatracurium,volume of urine and blood loss,postoperative nausea and vomiting,restlessness,shivering between the two groups(P>0.05).Conclusion:For general anesthesia of patients undergoing laparoscopic pancreaticoduodenectomy,theprecisionanesthesiamanagementof closed-loop target-controlled infusion system combined with goal-directed fluid therapy is better than the traditional anesthesia management,which can achieve accurate clinical anesthesia management.To improve the prognosis of patients.