Clinical observation on depth of anesthesia regulated by BIS and AAI in laparoscopic gynecologic surgery

Objective To investigate the value of the BIS and AAI in regulating the depth of anesthesia and stress in the laparoscopic gynecologic surgery.Methods Two hundred patients undergoing selected laparoscopic gynecologic surgery were enrolled and divided into four groups randomly.Each group included 50patients.The depth of anesthesia was regulated by different index.Group B is to keep the BIS at 40-55.Group A is to keep the AAI at 15-25.Group BA is to keep the BIS at 40-55and AAI at 15-25.Group C is to control the variability of blood pressure and the heart rate within 20%of basic level.The duration of anesthesia,the dose of propofol,the time of laryngeal extubation and the time to analepsia were recorded.Plasma concentration of glucose,epinephrine(E),βendorphin(β-EP)were measured at following time points:5min after coming into operation room(T0),one minute(T1)and three minute(T2)after artificial pneumoperitoneum,seperating pathological tissue with normal tissue(T3),and the end of operation(T4).Results The concentration of glucose,β-EP and E were significantly increased in four groups at T1-T4 when compared to those at T0(P0.05).Compared to group B,the concentration of glucose,β-EP and E at T1,T2,and T4in group A,BA,and C were decreased significantly(P0.05).The consumption of propofol was significantly lower in the group B than other groups(P0.05),while the time of analepsia in group B was earlier than other groups(P0.05).The consumption of phenylephrine in group BA was more than groups B and A(P0.05).The consumption of nicardipine and esmolol in group B was more than groups BA and A(P0.05).Conclusion Joint monitoring of BIS and AAI is more accurate for controlling the depth of anesthesia,hemodynamics and stress responses.