부산대학교 도서관

Introduction: Target controlled infusion is an intravenous anesthesia method in which anesthetics are delivered through an automated syringe in order to reach the desired plasma concentration according to a pre-established pharmacokinetic model. The objective of this study was to analyze the precision of the Marsh pharmacokinetic model for propofol administration in general anesthesia with oro-tracheal intubation in patients undergoing laparoscopic cholecystectomy and the assessment of some variables (age, gender, body mass index) in relation to bispectral index at different moments of the anesthesia. Material and methods: A number of 45 patients between 18 to 85 years old were included in our study with low preoperative ASA risk (I and II) with laparoscopic cholecystectomy. Exclusion criteria were represented by emergency interventions, ASA risk above II, known allergy to the used anesthetics. The monitoring procedures followed the standard ASA recommendations (blood pressure, pulse, SpO2, ECG, ventilation). The depth of sedation was assessed using bispectral analysis. After operation the patients were asked to fill an evaluation questionnaire (IOWA scale) about their satisfaction regarding the anesthetic procedure. Results: The correlation analysis of bispectral values at 3 and 5 minutes, at IOT and awakening in relation to the patients age, did not show statistically significant differences (p = 0.17, p = 0.73, p = 0.99, p=0.73). There was a difference in bispectral index values by gender. Thus, at 3 minutes, the bispectral index was 53.71(16.83 SD) in women, and 51.64 (19.53SD) in men. At 5 minutes was 46.74 (13.37SD) in women and 39.57 (13.47SD) in men. At IOT was 47.97 (10.52SD) in women and 40.50 (11.37SD) in men. The analysis of correlations between bispectral indexes at 5 minutes and gender showed statistically significant differences between men (p = 0.05) and women (p = 0.0001). The correlation analysis of bispectral values measured at 3 and 5 minutes and at IOT in relation to BMI did not show statistically significant differences (p = 0.38, p = 0.36, p = 0.83 respectively) Conclusions: The Marsh pharmacokinetic model is reliable providing a hypnosis with bispectral index values between 45.87-52.82 (SD11.17-17.55) with no risk of intra-anesthetic awakening. The body mass index has an influence on awakening time and the gender on the depth of hypnosis. Keywords: bispectral index, target controlled infusion, body mass index, plasma concentration, intra- [ABSTRACT FROM AUTHOR]