OBJECTIVE: To compare the effects of different target controlled infusions of propofol on the perioperative hemodynamics and awakening period of the elderly patients.

METHODS: Ninety-two elderly patients scheduled for abdominal surgeries were randomly divided into four groups for induction of anesthesia, 23 cases in each group: group I of plasma target controlled infusion of propofol, group II of effect-compartment target controlled infusion of propofol, group III of gradient plasma target controlled infusion of propofol, and group IV of gradient effect-compartment target controlled infusion of propofol. Hemodynamic indexes (cardiac index, mean arterial pressure, heart rate changes) were compared among four groups before anesthesia induction, after anesthesia induction but before intubation, during intubation, immediately after endotracheal intubation and 5 minutes after intubation. After termination of anesthesia, the situation of patients in awakening period, including breathing recovery time, the time to open eyes on verbal command, extubation time, restlessness, and the Observer’s Assessment of Alertness/Sedation (OAAS) score, was observed before anesthesia induction and 6, 24, 48 hours after surgery. Mini-Mental State Examination (MMSE) scoring was used for cognitive function assessment.

RESULTS AND CONCLUSION: (1) Cardiac indexes and mean arterial pressure in the four groups were significantly decreased before intubation compared with before anesthesia induction, while the heart rate increased significantly (P < 0.05). Compared with the other groups, the decreased amplitude in the cardiac index and mean arterial pressure were significantly lower in the group IV (P < 0.05), and the heart rate was also lower (P < 0.05) before intubation. There were no significant differences among the four groups during intubation, immediately after endotracheal intubation and 5 minutes after intubation. (2) The breathing recovery time, the time to open eyes on verbal command and extubation time were significantly shorter in the group IV than the other groups (P < 0.05), and restlessness and OAAS scores were also lower than the other groups (P < 0.05). (3) The MMSE score in each group was decreased after surgery compared with before anesthesia induction. Moreover, the MMSE score in the group IV was higher than that the other groups at 6 and 24 hours after surgery (P < 0.05). In conclusion, the results of this study indicate that the gradient effect-compartment target controlled infusion of propofol is preferred in the elderly patients, which has no influence on anesthesia effect, and can reduce the impact on the circulatory system and fasten recovery from anesthesia.