Objective: To investigate the best concentration ratio of propofol controlled-infusion combined with sevoflurane in anesthesia for patients undergoing laparoscopy.
Methods: One hundred patients undergoing cholecystectomy under laparoscopy were randomly divided into 5 equal groups treated with propofol controlled plasma at the concentrations of 1, 2, 3, 4, and 5 microg/ml respectively (Group 1-5). Bispectral index (BIS) was maintained at a range of 50 +/- 5 by adjusting sevoflurane inhalation. The end-tidal concentration of sevoflurane (ETsevo), systolic pressure, diastolic pressure, recovery time, awareness, and post-operative nausea and vomiting (PONV) within 24 h after operation were recorded. The best concentration ratio of propofol controlled-infusion combined with sevoflurane with the definition as the highest ETsevo without PONV decrease along with the increase of propofol concentration.
Results: ETsevo was negatively correlated with and propofol concentration. There were nit significant differences in the systolic pressure, diastolic pressure, and recovery time among different groups. No incidence of intra-operative awareness was found. The PONV rates of Group 1 and 2 were both 60%, significantly higher than those of the other 3 groups (all P < 0.05) without significant differences in PONV rate among Group 3 - 5. The best concentration ratio of propofol controlled-infusion combined with sevoflurane was propofol controlled-infusion at the concentration of 1 microg/ml with ETsevo at the concentration as 1 minimal alveolar concentration (MAC).
Conclusion: Propofol controlled-infusion at the concentration of 1 microg/ml with ETsevo at the concentration as 1 MAC is the best concentration ratio with low PONV rate and a possibility to prevent intra-operative awareness.
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