Comparative study: efficacy of closed-looptarget controlled infusion of cisatracurium and other administration methods for spinal surgery of elderly patients

X.-D. Ma, J. Yan, B.-Z. Dai, D.-Q. Kong, S.-Y. Du, B.-P. Li

Department of Anesthesiology, The First People’s Hospital of Xuzhou City, Xuzhou, China. hlpe124833@163.com

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• Pharmacology

OBJECTIVE: To observe the efficacy of traditional administration, continuous pump injection, and closed-loop target controlled infusion of cisatracurium to determine the optimal method of drug administration, and to establish the individualized and rational administration of muscle relaxants in elderly patients.

PATIENTS AND METHODS: A total of 150 patients who underwent spinal surgery under tracheal intubation general anesthesia in our hospital from August 2013 to April 2015 were selected. All patients were administered with general anesthesia and randomly divided into three groups: group A (n = 50) was treated under closed-loop target controlled infusion (CLTCI), group B (n = 50) was treated under muscle relaxation monitoring, and group C (n = 50) was treated under continuous pump injection. Hemodynamic changes and blood oxygen saturation of the three groups were observed, and the muscle relaxation recovery, dosage, and bleeding of the three groups were compared.

RESULTS: MAP and HR of group A were significantly lower than those of group B and group C (p < 0.05). There were no cases of insufficient muscle relaxation in group A, five cases in group C, and 14 cases in group B, and the differences between any two groups were statistically significant (p < 0.05). Regarding muscle relaxation recovery, the time (T¬¬1) of recovery from 10%-25% and 25%-75%, and the time from drug withdrawal to recovery to TOFr from 0.7-0.9 of group A were the shortest, followed by group C and group B. The differences between any two groups were statistically significant (p < 0.05). The total dosage of cisatracurium of group A was the least, followed by group C and group B, and differences between any two groups were statistically significant (p < 0.05). Moreover, the bleeding volume of group A (235.2 ± 141.3 ml) was smaller than in group B (353.1 ± 173.8 ml) and group C (316.5 ± 155.2 ml), and differences between the three groups were statistically significant (p < 0.05).

CONCLUSIONS: For spinal surgery of elderly patients, closed-loop target controlled infusion of cisatracurium was superior to continuous infusion and intravenous injection. The time of muscle relaxation recovery was shortened, the dosage of cisatracurium was reduced, and the number of cases of insufficient muscle relaxation was reduced.

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