Abstract:

AIM: To study the feasibility of closed-loop muscle relaxant injection system(CLMRIS) in traditional laparotomy.  METHODS: 90 ASA I-II patients undergoing traditional laparotomy under total intravenous anesthesia were randomly divided into three groups: group E(administration by CLMRIS), group C(administration by experience) and group EC (administration combined CLMRIS with experience) using the random number table method. The TOF value at different points, the onset time of muscle relaxant, the time from induction to intubation, induced dosage, intubation condition score, total dosage of muscle relaxant, duration of surgery and anesthesia, recovery time and recovery index, the intraoperative frequency of body movement, extubation agitation score, PACU retention time and the satisfaction scores of anesthesiologist and operation doctor were all detected and recorded. RESULTS: No significant difference was observed between the general situation, operation time, anesthesia time, recovery index, onset time of muscle relaxant and the frequency drug delivery (P>0.05).All groups were able to meet the requirements of muscle relaxation during operation. During induction of anesthesia, intubation time of group E and group EC were longer than group C, but with higher intubation score and smoother intubation process (P<0.05). During the maintenance of anesthesia, group E consumed more vecuronium and demonstrated faster average infusion speed of vecuronium than the other two groups, but presented with fewer body movement (P<0.05). During the anesthesia recovery stage, group E was faster than the other two groups recovering from anesthesia with higher value of TOF and shorter retention time in PACU (P<0.05). CONCLUSION: The CLMRIS can accurately recognize the intubation time and provide better conditions to intubation in the course of anesthesia induction. It can also provide good muscle relaxation condition with less body movement during operation while shorten the recovery time and the time stay in PACU postoperative as well. Therefore, the CLMRIS can be safely and effectively used in patients on upper abdominal open surgery under anesthesia, and muscle relaxation monitoring is referential for clinical application.

Key words: closed loop muscle injection system, feasibility, upper abdominal laparotomy