The application of propofol target controlled infusion in the total thoracoscopic mitral valve replacement

Zhagn Hui; Chen Wei; Lei Chong; Chen Min

doi:10.13498/j.cnki.chin.j.ecc.2015.02.05

Abstract：Objective To observe the safety and efficacy of the propofol target controlled infusion in the total thoracoscopic mi?tral valve replacement. Methods A hundred and tenpatients with ASA grade II - III rheumatic mitral valve disease for total thoraco?scopic mitral valve replacement were randomly assigned to TCI group and N-TCI group, 55 cases in each group. In TCI group ,propo?fol target controlled infusionwas used for induction and maintenance, and N-TCI group propofol single injection was for induction and continuous infusion for maintenance. Both groups used high dose sedative analgesics under extracorporeal circulation for total thoraco?scopic mitral valve replacement. Observed changes in the incidence of hypotension during the induction phase, the basic clinical param?eters of patients, the dosage of vasopressors and propofol during induction and maintance, the operation time, CPB time, clamping time, awake time, mechanical ventilation time, extubation time, ICU stay time and postoperative complications in both groups were re?corded. Results The incidence of hypotension during induction in TCI group was significantlylower than N-TCI group (21.8%vs 45. 5%, P =0.007). The dosage of propofol during the induction and maintaince period in TCI group were less than N-TCI group ((62.3 ±17.7)mg vs (85.9±24.4)mg,( P=0.002), and (640.8±159.7)mg vs (843.5±283.7)mg, ( P=0.001)).The awake time ((1.9±0. 6)h vs (3.3±0.9)h, ( P =0.011)), mechanical ventilation time((11.1±6.8)h vs (15.9±8.2)h, ( P =0.024)) and extubation time ((11.7±6.9)h vs (16.5±8.3)h, ( P=0.028)) in TCI group were significantly shorter than N-TCI group. The incidence of postoper?ative lung infection in hospital in TCI group was lower than N-TCI group(0 vs 7.3%, P =0.049). Conclusion Propofol target con?trolled infusion can be safely used in total thoracoscopic mitral valve replacement.It can maintain stable hemodynamics, shorten postop?erative recovery time and reduce postoperative lung infection obviously.