Closed-loop versus open-loop target-controlled infusion of propofol under the guidance of Bispectral index in total intravenous anesthesia: a meta-analysis
GUO Jing
YANG Gaisheng
TAO Tianzhu
LU Manman
Abstract：Objective To systematical assess the efficacy of closed-loop target-controlled infusion (TCI) of propofol and open-loop TCI of propofol under the guidance of Bispectral index (BIS) during the maintenance phase of total intravenous anesthesia.Methods We screened PubMED, Web of Science, EMBASE, the Cochrane Library, CNKI, VIP, WanFang, and CDMD to identify the randomized controlled trials (RCTs) on the efficacy of propofol with closed-loop TCI versus open-loop TCI under the guidance of BIS in the total intravenous anesthesia.The included trials were evaluated by using the Cochrane Collaboration's tool.The meta-analysis was conducted by using Revman5.0.Results Six eligible RCTs involving 680 patients were identified in our meta-analysis, including 341 cases of closed-loop TCI (closed-loop group) and 339 cases of open-loop TCI (open-loop group).The percentage of full anesthesia time in the total anesthesia of the closed-loop group was higher than that in the open-loop group (WMD=12.68, 95% CI 7.92-17.43, P<0.01).The percentage of light anesthesia duration in the total anesthesia was lower than that of the open-loop group (WMD=-1.38, 95% CI: from-2.24 to-0.51, P<0.01).The percentage of deep anesthesia duration in the total anesthesia was lower than that of the open-loop group (WMD=-9.80, 95% CI: from-18.51 to-1.09, P<0.05).The propofol dosage was significantly less than that of the open-loop group (WMD=-0.28, 95% CI: from-0.53 to-0.03, P<0.05).There was no statistically significant difference in the incidence of physical reaction between the two groups (RR=0.98, 95%CI:0.58-1.68, P=0.95), as well as in the postoperative extubated time between the two groups (WMD=-1.36, 95% CI: from-2.69 to-0.02, P=0.05).Conclusion Compared with open-loop TCI, during the maintenance phase, the closed-loop TCI could control the depth of anesthesia more accurately, and it could significantly reduce the dosage of propofol.
Keywords：total intravenous anesthesiageneral anesthesiapropofoltarget-controlled infusionopen-loopclosed-loopbispectral indexmeta-analysis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 20-23 )