The Application of a Closed-Loop Target-Controlled Infusion System Guided by Multimodal Brain Monitoring in Colorectal Cancer Surgery

The Application of a Closed-Loop Target-Controlled Infusion System Guided by Multimodal Brain Monitoring in Colorectal Cancer Surgery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Application of a Closed-Loop Target-Controlled Infusion System Guided by Multimodal Brain Monitoring in Colorectal Cancer Surgery Shifeng He, Zefei Zhu, Zhentao Sun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8775750/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives Evaluating the Safety and Superiority of a Closed-Loop Target-Controlled System Guided by Multimodal Brain Function Monitoring in Colorectal Surgery Patients. Methods Patients who underwent radical resection for colorectal cancer under general anesthesia were randomly assigned to either the closed-loop target-controlled group (Group A) or the manual adjustment group (Group B). In Group A, anesthesia induction and maintenance were achieved by automatically adjusting the infusion rates of remifentanil and propofol via the closed-loop target-controlled system. Group B underwent anesthesia induction and maintenance through manual adjustment. The target range for the wavelet index (WLi) and pain threshold index (PTi) was set at 40 ~ 60 for both groups. The following parameters were recorded: patient demographics and surgical indicators; intraoperative propofol and remifentanil dosages; systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and regional oxygen saturation (rSO 2 ) at various time points; intraoperative norepinephrine dosage; preoperative and postoperative hemoglobin, creatinine, and lactate levels; extubation time; postanaesthesia care unit (PACU) stay duration; and length of hospital stay; and the occurrence of intraoperative awareness and postoperative complications within 7 days. Results Compared with Group B patients, Group A patients had significantly lower intraoperative propofol consumption ( P < 0.05); the intraoperative norepinephrine dosage and lactate levels upon PACU admission were significantly lower in Group A patients than in Group B patients ( P < 0.05); and Group A patients presented more stable perioperative mean arterial pressure (MAP) and regional oxygen saturation (rSO₂). Compared with Group B patients, Group A patients had significantly shorter extubation times and PACU stay durations ( P < 0.05). However, no statistically significant differences were observed between the two groups in terms of hospital stay duration, intraoperative awareness, or postoperative complications within 7 days ( P > 0.05). Conclusions Compared with manual adjustment, closed-loop target-controlled systems guided by multimodal brain function monitoring offer more benefits for patients undergoing colorectal surgery. Trial Registration This study was approved by the Scientific Research and Clinical Trials Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No.2021-KY-1106-002), registered in the China Clinical Trial Registry (Registration No.ChiCTR2100049859,registration date on 08/10/2021). Precision Anesthesia Multimodal Brain Monitoring The Closed-Loop Target-Controlled Infusion System Hypotension Postoperative delirium Figures Figure 1 Introduction Radical resection of colorectal cancer under general anesthesia is the preferred treatment method for this disease [ 1 ] . Factors such as prolonged operative time, excessive intraoperative blood loss, and propofol overdose can lead to intraoperative hypotension in patients [ 2 ] . Hypotension increases the risk of intraoperative mortality in colorectal cancer patients. Therefore, precise regulation of anesthetic medications is crucial [ 3 ] . Traditional intraoperative anesthesia management relies primarily on anesthesiologists manually adjusting parameters on the basis of limited monitoring indicators and clinical experience. During surgery, a patient's physiological state can change rapidly, and monitoring a single parameter often fails to comprehensively reflect the depth of anesthesia and analgesia. This leads to risks such as intraoperative awareness or excessive anesthesia depth [ 4 ] . Modern clinical anesthesia is evolving toward greater precision and individualization. Advances in monitoring technologies have enabled precise intraoperative drug administration [ 5 ] . Recently, multimodal physiological data monitoring and intelligent closed-loop control have gained increasing attention: by integrating multiple vital signs, such as electroencephalogram (EEG), cerebral oxygenation (rSO₂), and hemodynamics, these approaches achieve a more comprehensive perception of the patient's anesthetic state [ 6 ] . The closed-loop target-controlled system guided by multimodal brain function monitoring comprises noninvasive EEG sensors, TCI pumps, vital sign monitors, anesthesia depth monitors, an intelligent integrated hub, and a surgical anesthesia information system. The anesthesia depth monitor collects frontal lobe EEG signals via noninvasive sensors. Wavelet algorithms decompose these signals into cortical and subcortical components, extracting functional indices such as the wavelet index (WLi), pain threshold index (PTi), and cognitive index (Cogi). Vital sign monitoring uses a cerebral oxygenation module to collect cerebral oxygen saturation alongside vital parameters such as heart rate and blood pressure. The intelligent control center receives and processes these monitoring data to dynamically adjust the TCI target-controlled infusion rate. This study investigated the clinical efficacy of a closed-loop target-controlled system guided by multimodal brain function monitoring for general anesthesia in colorectal surgery patients. Methods 2.1 Patients This study is a randomized controlled trial. This study was approved by the Research and Clinical Trial Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No. 2021-KY-1106-002) and registered with the China Clinical Trial Registry (Registration No. ChiCTR2100049859). All patients provided written informed consent. Patients who underwent laparoscopic radical resection for colorectal cancer at the First Affiliated Hospital of Zhengzhou University between June 2022 and December 2024 were selected. The inclusion criteria were as follows: age ≥ 18 years and American Society of Anesthesiologists (ASA) physical status I–II. The exclusion criteria were as follows: preoperative coagulation abnormalities; preoperative atelectasis, pulmonary bullae, or severe chronic obstructive pulmonary disease; severe systemic diseases (cardiac, hepatic, renal, etc.) prior to surgery; and preoperative psychiatric disorders or prolonged use of psychotropic medications. A total of 100 patients were enrolled and randomly assigned via a random number table to either the closed-loop target-controlled infusion group (Group A) or the manually adjusted infusion group (Group B) (Fig. 1). Patients were randomly divided into two groups using a random number table method. An independent statistician prepared sequentially numbered, opaque, and sealed envelopes containing group allocation information, which were stored in the operating room. After confirming that the patient met the inclusion criteria and obtaining written informed consent, a designated anesthesiologist (who was not involved in patient recruitment, data collection, or analysis) opened the envelope, thereby ensuring allocation concealment. All experimental equipment used the same manufacturer and model to ensure blinding of patients, surgeons, and outcome assessors. Data collectors were professionally trained, did not participate in anesthesia administration, and were unaware of group allocation. 2.2 Anesthesia methods All patients were instructed to fast and abstain from drinking water prior to surgery. Preoperatively, peripheral venous access was established, oxygen therapy was initiated, and patients were connected to cardiac monitoring and a total depth of anesthesia monitoring. Noninvasive EEG sensors and cerebral oximetry probes were properly applied. Under local anesthesia, radial artery catheterization and right internal jugular vein catheterization were performed. After 3 minutes of oxygen administration, Group A received propofol with an initial target plasma concentration of 1.5 µg/ml, which was increased by 0.5µ g/ml every 2 minutes. Group B received 2 ~ 4 mg/kg propofol. Consciousness levels were continuously monitored in both groups until loss of consciousness occurred. Subsequently, intravenous boluses of alfentanil (50 µg/kg) and rocuronium bromide (0.6 mg/kg) were administered. Tracheal intubation was performed after neuromuscular blockade was effective. During the maintenance phase, remifentanil infusion was initiated. Group A had a target plasma concentration of 3 ng/mL for remifentanil, whereas Group B had a remifentanil infusion rate of 0.05 ~ 2 µg/kg/min. Both groups set target values for WLi and PTi at 40 ~ 60. In Group A, the target-controlled system automatically adjusted the target TCI concentration on the basis of WLi and PTi, dynamically regulating the propofol and remifentanil infusion rates. In Group B, anesthesiologists manually adjusted the propofol and remifentanil infusion rates according to the monitored indicators to maintain WLi and PTi at the same target values. When the MAP is < 65 mmHg or the SBP is 3 minutes, cerebral perfusion and oxygenation were maintained through neuroprotective measures, including timely application of ice caps, increased oxygen concentration, ventilator parameter adjustments, and maintenance of blood pressure and CO₂ within normal ranges. Both groups underwent volume-controlled ventilation with the tidal volume set at 6–8 mL/kg, an inspiratory-to-expiratory ratio of 1:2, an oxygen flow rate of 2 L/min, and an appropriately adjusted respiratory rate to maintain the P ET CO₂ at 35 ~ 45 mmHg. Rocuronium bromide (0.15 mg/kg) was intermittently administered as needed. All patients underwent surgery by the same team of skilled surgeons, with identical laparoscopic incisions and intraoperative CO₂ insufflation pressures maintained at 12 mmHg. At the conclusion of skin closure, the infusion of remifentanil and propofol was discontinued, followed by intravenous bolus administration of 5 mg dexmedetomidine and 0.25 mg palonosetron. Following surgery, patients were transferred to the PACU. After the patient regained consciousness, the endotracheal tube was removed. Patients were discharged back to their ward once their Aldert nursing score reached 10 points. 2.3 Data collection This study primarily collected clinical data from patients with colorectal cancer, including age, sex, height, weight, BMI, ASA classification, preoperative hemoglobin, creatinine levels, surgical procedure type, preincision lactate levels, operative duration, anesthesia duration, total fluid administration, blood loss, urine output, HR, SBP, DBP, MAP and rSO 2 at various intraoperative time points, intraoperative propofol and remifentanil dosages, intraoperative norepinephrine dosage, postoperative hemoglobin, postoperative creatinine, lactate levels upon PACU admission, postoperative extubation time, PACU duration, hospital stay, intraoperative awareness and complications within 7 days post-operatively. During surgery, the patient's heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and relative oxygen saturation (rSO₂) values must be recorded at specific time points: before anesthesia induction (T 0 ), 5 minutes after anesthesia induction (T 1 ), at the start of surgery (T 2 ), 1 hour after surgery commencement (T 3 ), and at the conclusion of surgery (T 4 ). 2.4 Definitions Postoperative complications include pneumonia, acute kidney injury, postoperative delirium, wound infection, and urinary tract infection. Acute kidney injury is defined as an increase in serum creatinine levels exceeding 26.4 µmol/L within 48 hours [ 7 ] . Postoperative delirium is assessed via the CAM scale [ 8 ] . 2.5 Statistical analysis Sample size estimation was performed via PASS 2021. On the basis of pretrial results, we projected a minimum 8% reduction in propofol usage in the automated closed-loop target-controlled infusion group. With a significance level of α = 0.05, 1-β = 0.8, and a 20% dropout rate, the sample size calculation indicated a minimum of 40 subjects per group. Therefore, this study enrolled 100 subjects on the basis of the estimated sample size. Data analysis was performed via SPSS 23.0 software. Normally distributed continuous data are presented as the means ± SDs, and intergroup comparisons were conducted via independent samples t tests. Nonnormally distributed continuous data are presented as M (P25, P75). Intergroup comparisons were performed via the Mann‒Whitney U test, whereas intragroup comparisons at different time points were analyzed via repeated-measures ANOVA. Categorical data are expressed as cases (%). Intergroup comparisons were conducted via the chi-square test or Fisher's exact test. P < 0.05 was considered statistically significant. Results This study included 100 patients. Group A (the experimental group) received anesthesia guided by a closed-loop target-controlled system via multimodal brain function monitoring, whereas Group B (the control group) received anesthesia with manually adjusted drug dosages. Each group comprised 50 patients. First, basic patient characteristics were compared between groups. No significant differences were observed in age, sex, weight, height, BMI, ASA classification, or surgical type ( P > 0.05), as shown in Table 1 . Second, no statistically significant differences in preoperative hemoglobin, preoperative creatinine, preoperative lactate, duration of surgery, duration of anesthesia, total fluid administration, blood loss, or urine output ( P > 0.05) were detected between the groups, as shown in Table 2. Compared with Group B patients, Group A patients required a reduced propofol dosage ( P < 0.05) and decreased norepinephrine usage ( P < 0.05). Lactate levels upon PACU admission were significantly lower in Group A than in Group B ( P < 0.05). Compared with Group B patients, Group A patients had significantly shorter extubation times and PACU stay durations ( P < 0.05). There were no statistically significant differences between the two groups in terms of intraoperative remifentanil dosage, postoperative hemoglobin levels, creatinine levels, or length of hospital stay ( P > 0.05), as shown in Table 2. Within-group comparisons revealed that HR values at T 0 were significantly greater than those at subsequent time points ( P < 0.05). Compared with those at T 0 , SBP, DBP, MAP, and rSO₂ at T1 were significantly lower in both groups ( P < 0.05). At T 2 , SBP, DBP, MAP, and rSO₂ were significantly elevated compared with those at T1 ( P < 0.05). The T 3 values decreased significantly compared with those in T 2 ( P 0.05). At T 1 , the DBP of Group A was significantly greater than that of Group B ( P 0.05). At T 1 and T 3 , Group A's SBP, MAP, and rSO₂ were significantly greater than those of Group B ( P 0.05), as shown in Table 3 . Table 4 indicates that no intraoperative awareness occurred in either group. There were no statistically significant differences between the two groups in terms of the incidence of postoperative delirium, pneumonia, postoperative nausea and vomiting, acute kidney injury, or urinary tract infection ( P > 0.05). Discussion With the advancement of personalized anesthesia concepts, “precision anesthesia” has become the goal of modern anesthesia management. Its key lies in real-time adjustment of anesthesia depth on the basis of patient variability and surgical characteristics, ensuring that surgical requirements are met while maximizing protection of brain function and vital organ perfusion [ 9 ] . Precision intraoperative drug administration, monitoring, and management are essential components of precision anesthesia. By precisely controlling anesthetic drug dosage and timing, patient surgical experience and postoperative recovery quality can be significantly enhanced [ 10 – 11 ] . In precision anesthesia management, a single parameter often fails to comprehensively reflect the complex state of brain function. A multimodal neural monitoring approach that combines electroencephalography (EEG) with near infrared spectroscopy (NIRS) offers a more comprehensive solution for precision anesthesia management [ 12 ] . EEG provides dynamic information on anesthesia depth and central nervous system function, reflecting the degree of drug-induced suppression of brain electrical activity. Brain oxygen monitoring, which is based on near-infrared spectroscopy (NIRS) principles, enables real-time, continuous assessment of the oxygenation status of local brain tissue. Superficial and deep detection via forehead probes reflect subcutaneous and cortical oxygenation levels, respectively. Continuous monitoring of regional brain oxygen saturation (rSO₂) assists anesthesiologists in the early identification of cerebral hypoperfusion or systemic hypoxia risk [ 13 – 14 ] . Anesthetic induction often causes large numbers of neurons to be synchronously inhibited, resulting in regular and slow brain rhythms and a subsequent decrease in the sedation index. This state of low sedation corresponds to loss of consciousness and sensory isolation, which are typical manifestations of anesthetic effects. However, if excessive anesthesia leads to prolonged burst suppression, the EEG will exhibit alternating periods of flatline and high-amplitude bursts accompanied by a marked decrease in rSO₂. This phenomenon is often interpreted as a sign of severe suppression of brain function or even impending danger [ 15 ] . Excessive anesthesia depth is closely associated with the occurrence of postoperative delirium (POD) [ 16 ] , and the incidence of postoperative delirium in patients over 65 years of age can reach as high as 50% [ 17 ] . Currently, the bispectral index (BIS) is the most widely used tool for monitoring anesthesia depth in clinical settings, whereas wavelet algorithms represent a technological innovation in neurophysiological monitoring. For the vast majority of nonstationary signals (such as EEG signals), the wavelet algorithm employing wavelet exponents is more suitable than the Fourier transform used in BIS, as it effectively mitigates the influence of analgesia and muscle relaxation levels on sedation depth [ 18 – 19 ] . The incidence of intraoperative awareness in patients was 0% in this study. This further demonstrates the safety of EEG wavelet monitoring technology. Compared with the manual control group, the closed-loop target-control group used less propofol during surgery, with an average reduction of 10 mg ( P < 0.01); had shorter postoperative recovery times, with an average reduction of 3 minutes ( P < 0.05); and spent less time in the PACU, with an average reduction of 10 minutes ( P 0.05), indicating that both groups had identical baseline cerebral oxygenation states. The closed-loop target-controlled group showed a significant decrease in the rSO₂ only at 5 minutes after the induction of anesthesia (T 1 ) ( P 0.05). The manual control group presented a significant downward trend in rSO₂ at both T 1 and T 3 ( P < 0.05). At both T 1 and T 3 , the rSO₂ in the closed-loop target-control group was significantly greater than that in the manual control group ( P < 0.05). These results indicate that the closed-loop target-controlled group experienced a smaller decrease in rSO₂ relative to baseline and a more stable trend during both the induction and maintenance of anesthesia. Additionally, the incidence of postoperative delirium (POD) in both groups was lower than that reported in previous studies [ 20 ] (4%~10% vs. 11.1%~50%), with fewer cases occurring in the closed-loop target-controlled group (2 vs. 5). These findings indicate that combined intraoperative EEG and rSO₂ monitoring optimizes the anesthetic depth and balance between the brain oxygen supply and demand, thereby reducing the sedative dosage and lowering the incidence of postoperative delirium and cognitive impairment. Precise closed-loop target control maintains more stable rSO₂ indices, which holds significant value for improving patients' short-term outcomes. Precision anesthesia management focuses not only on monitoring the central nervous system but also on prioritizing perfusion and protection of vital organs throughout the body. Intraoperative hemodynamic monitoring is central to achieving this goal, with the key objective being to maintain appropriate perfusion pressure and tissue oxygenation to ensure that the metabolic demands of vital organs are met [ 21 ] . The mean arterial pressure (MAP) is one of the most important clinical indicators in hemodynamic monitoring [ 22 ] . Patients with colorectal cancer experience significant intraoperative blood and fluid loss, which may impair the self-regulatory capacity of the brain, heart, and kidneys. This leads to heightened sensitivity of these organs to hypoperfusion. Numerous studies have demonstrated that maintaining an intraoperative mean arterial pressure (MAP) ≥ 65 mmHg reduces the incidence of perioperative complications [ 23 ] . In this study, sedation and analgesia indices were continuously monitored in the closed-loop target-controlled group (Group A), the values were compared against the target values, deviations were calculated, and the infusion rates of propofol and remifentanil were adjusted accordingly. The results revealed no significant difference in the baseline MAP values between the experimental group and the control group ( P > 0.05). The MAP value in the closed-loop target-control group significantly decreased only at 5 minutes after the induction of anesthesia (T 1 ) ( P 0.05). The MAP values in the control group decreased significantly at T 3 , T 4 , and T5 (P < 0.05). At time point T 1 , the MAP value in the experimental group was significantly greater than that in the control group (P < 0.05). Compared with those in the control group, patients in the closed-loop target-controlled infusion group (Group A) had significantly lower norepinephrine dosages, with an average decrease of approximately 16 µg ( P < 0.01). Postoperative blood lactate levels in Group A were significantly lower than those in Group B ( P < 0.05). The results fully demonstrate that the use of a closed-loop target-controlled anesthesia system guided by multimodal brain function monitoring during general anesthesia reduces the incidence of intraoperative hypotension in patients, decreases the dosage of vasoactive drugs, and thereby better maintains organ perfusion. This study also has several limitations. First, to ensure surgical safety, manual intervention was required to maintain normal parameters when WLi and PTi values exceeded 60 and persisted for more than 3 minutes. Second, the closed-loop target-controlled system lacks the capacity to handle complex situations. When dangerous conditions such as massive intraoperative bleeding occur, anesthesiologists must promptly resolve the issue. Finally, the selection of surgical procedures in this study was limited. Further research is needed to determine whether different types of surgery influence the study outcomes. In summary, this study employs target-controlled infusion technology to precisely regulate anesthetic effects, utilizes brain wavelet index monitoring to assess sedation depth and prevent anesthetic overdose or underdose, employs injury sensitivity index monitoring to guide rational analgesic drug administration, and employs brain oxygen level monitoring to evaluate cerebral tissue oxygen supply. This approach facilitates a transition from traditional experience-based management to a new phase guided by neurological function. Simultaneously, the closed-loop target-controlled system guided by multimodal brain function monitoring reduces the number of repetitive tasks for anesthesiologists, enabling them to focus more on addressing critical challenges during surgery and enhancing medical efficiency and safety. Multimodal data fusion (integrating signals such as heart rate variability, pupil monitoring, and facial electromyography) will lead to more comprehensive patient status assessments and smarter system decision-making. Its clinical application is expected to expand beyond colorectal surgery into more complex fields, such as cardiac and neurosurgical fields [ 24 ] . Abbreviations Abbreviations The full term or phrase WLi The wavelet index PTi pain threshold index SBP systolic blood pressure DBP diastolic blood pressure MAP mean arterial pressure HR heart rate rSO 2 regional oxygen saturation PACU postanaesthesia care unit EEG electroencephalogram Cogi cognitive index ASA American Society of Anesthesiologists NIRS near infrared spectroscopy POD postoperative delirium BIS the bispectral index Declarations Ethics approval and consent to participate This study was approved by the Scientific Research and Clinical Trials Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No.2021-KY-1106-002), registered in the China Clinical Trial Registry (Registration No.ChiCTR2100049859). All patients provided written informed consent.This study adhered to the guidelines established by the Consolidated Standards of Reporting Trials (CONSORT) and complied with the Declaration of Helsinki. Consent for publication Not applicable. Availability of data and materials The datasets generated during and/or analyzed during the current study are not publicly available due to privacy requirements but are available from the corresponding author upon reasonable request. Competing Interests The authors declare that they have no conflicts of interest. Funding : This study was supported by the Henan Provincial Science and Technology Research Project (2018010006). Author’s contributions : Study design: SH, ZZ, ZS. Study conduct: SH, ZZ, ZS. Data analysis:SH. Writing paper: SH, ZZ, ZS. All authors read and approved the final manuscript version. Acknowledgements The authors sincerely appreciate the invaluable contributions of all participants, without whom this research would not have been possible. References Li M, Hu J, Suo L, et al. Efficacy of laparoscopic radical resection of right-sided colon cancer by different surgical approaches: network-meta-analysis[J]. BMC Surg. 2024;24(1):347. Nguyen NT. 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Tables TABLE 1 Comparison of basic patient information Group A（N=50） Group B（N=50） t/ c 2 P Age(years) 58.06±12.92 59.58±11.44 0.623 0.535 Gender（Male/Female） 30/20 31/19 0.042 0.838 Weight（kg） 67.42±10.27 65.73±10.85 0.800 0.462 Height（cm） 166.66±8.03 165.86±7.65 0.510 0.611 BMI(kg/m 2 ) 24.21±2.85 23.81±3.11 0.671 0.504 ASA Classification（Ⅱ/Ⅲ cases） 8/42 7/43 0.078 0.779 Types of Surgery Radical Resection for Colorectal Cancer/Rectal Cancer（cases） 20/30 14/36 1.604 0.205 BMI, Body Mass Index; ASA Classification, American society of Aneshesiologists (ASA) physical status classification system; Types of Surgery include radical resection for colorectal cancer and radical resection for rectal cancer. TABLE 2 Comparison of important clinical data related to surgery Group A（N=50） Group B（N=50） t/Z P Preoperative Hemoglobin（g/L） 126.56±20.11 128.14±20.77 0.386 0.700 Preoperative serum creatinine（mmol/L） 67.31±13.35 64.88±17.55 0.779 0.438 Preoperative blood lactate（mmol/L） 0.86±0.59 0.74±0.42 1.177 0.242 Duration of surgery（min） 197.34±58.18 216.18±57.84 1.624 0.108 Duration of anesthesia（min） 232.04±64.79 249.80±69.15 1.325 0.188 Total fluid intake（ml） 2429.00±448.25 2460.60±479.12 0.341 0.734 Blood loss（ml） 111.00±60.85 122.00±62.40 0.892 0.374 Urine output（ml） 625.00±343.49 565.50±370.00 0.832 0.407 Remifentanil dosage（mg） 2.43±0.87 2.76±0.90 1.887 0.062 Propofol dosage（mg） 38.92±13.10 48.51±15.34 3.361 0.001 Norepinephrine dosage (mg) 0(0,8) 16(0,32) 5.368 0.000 Postoperative blood lactate (mmol/L) 0.70(0.50,1.10) 0.75(0.60,1.53) 2.068 0.039 Postoperative hemoglobin（g/L） 116.02±17.02 114.96±17.43 0.308 0.759 Postoperative creatinine （mmol/L） 67.71±15.40 67.34±19.63 0.104 0.918 Extubation time（min） 18(16,21) 21(17,34) 2.397 0.017 PACU Stay Duration（min） 50(40,62) 60(53,67) 2.940 0.003 Length of hospital stay（days） 9(7,10) 8(7,11) 0.158 0.874 TABLE 3 Intragroup and intergroup comparisons of HR, SBP, DBP, MAP, and rSO₂ at different time points Group N HR(次/分) F T 0 T 1 T 2 T 3 T 4 A 50 71.12±13.31 66.36±12.37 a 58.08±8.16 ab 59.10±9.70 ab 59.76±9.20 ab 10.960 ** B 50 71.58±13.88 65.24±11.66 a 59.76±9.52 ab 62.74±10.12 a 65.54±11.66 ac 11.321 ** F 0.029 0.217 0.898 3.372 7.569 ** Group SBP(mmHg) F T 0 T 1 T 2 T 3 T 4 A 137.00±14.00 123.40±14.24 a 140.66±13.09 b 126.64±14.05 ac 128.00±15.87 ac 14.728 ** B 136.90±18.20 108.78±16.07 a 137.74±19.68 b 119.76±13.70 abc 124.96±19.91 abc 52.077 ** F 0.001 23.183 ** 0.763 6.147 * 0.713 Group DBP(mmHg) F T 0 T 1 T 2 T 3 T 4 A 75.94±10.30 68.84±9.91 a 79.66±12.42 b 73.28±10.36 c 70.34±10.91 ac 9.420 ** B 75.12±11.03 61.74±9.67 a 79.52±17.13 b 70.86±11.45 bc 67.88±12.91 abc 28.472 ** F 0.148 13.149 ** 0.002 1.228 1.060 Group MAP(mmHg) F T 0 T 1 T 2 T 3 T 4 A 97.24±10.08 88.40±10.08 a 102.06±13.18 b 92.30±11.80 bc 92.40±12.41 c 12.721 ** B 96.92±9.91 77.70±9.32 a 102.08±16.84 b 87.26±12.44 abc 90.06±17.10 abc 50.564 ** F 0.026 30.388 ** 0.000 4.322 * 0.613 Group rSO 2 （%） F T 0 T 1 T 2 T 3 T 4 A 64.41±2.99 62.62±2.88 a 64.42±2.77 b 63.75±3.40 65.30±3.52 9.075 ** B 64.56±3.34 59.00±3.34 a 63.72±2.96 b 61.50±4.31 abc 63.62±3.80 b 60.584 ** F 0.052 33.688 ** 1.473 8.394 ** 5.235 * *P<0.05 , **P<0.01; 与 T0 时比较 , aP <0.05;与T 1 时比较, b P <0.05;与T 2 时比较 , cP <0.05. TABLE 4 Comparison of intraoperative adverse events and postoperative complications in patients Group A（N=50） Group B（N=50） c 2 P 值 Intraoperative awareness（%） 0(0.0) 0(0.0) 0.000 1.000 Pneumonia（%） 2(4.00) 5(10.00) 1.382 0.240 Acute Kidney Injury（%） 0(0.0) 1(2.00) 1.010 0.315 Postoperative delirium（%） 2(4.00) 5(10.00) 0.614 0.433 Postoperative nausea and vomiting（%） 5(10.00) 4(8.00) 0.122 0.727 Infection of the Wound（%） 1(2.00) 3(6.00) 1.042 0.307 Additional Declarations No competing interests reported. Supplementary Files CONSORTChecklist.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8775750","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":595200389,"identity":"7c9a2a54-0530-4a75-9dd5-2b47331f5af4","order_by":0,"name":"Shifeng He","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Shifeng","middleName":"","lastName":"He","suffix":""},{"id":595200390,"identity":"5001526b-5b66-4a15-a0c9-5a8e74da66b3","order_by":1,"name":"Zefei Zhu","email":"","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":false,"prefix":"","firstName":"Zefei","middleName":"","lastName":"Zhu","suffix":""},{"id":595200391,"identity":"bbdd6842-f4be-470c-a4df-16dd01196384","order_by":2,"name":"Zhentao Sun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYLCCByCCmfnwgw8GNnbEaGBsSABR7GxphjMK0pJJ0MLPYyDN8+EQYwMh9fLuvccfJFTUJW5nZjAwtjE4wMzAfvjoBnxaDM+cS2xIOHM4cWczQ8LjHIM7fAw8aWk38GqZkWPYkNh2IHHDYYYDxjkGz5gZJHjM8GuZ/wao5V8dUAtjg7SFAZAkpEVeggeopYEZqIWZQZqBGC0GPDmGMxKOHTbecJiNzbDHIC2ZjZBf5NvPGHz4UFMnu+H8+c8PfvyxseNnP3wMvy0H0EXY8CkH29JASMUoGAWjYBSMAgAua09My3uQFAAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Zhengzhou University","correspondingAuthor":true,"prefix":"","firstName":"Zhentao","middleName":"","lastName":"Sun","suffix":""}],"badges":[],"createdAt":"2026-02-03 12:24:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8775750/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8775750/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103399911,"identity":"f3722b72-e805-4396-9068-4cc1ee95cdec","added_by":"auto","created_at":"2026-02-25 09:13:17","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":79121,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8775750/v1/e1cb4e9dd127ab53ff6c9574.png"},{"id":103819755,"identity":"e520fb48-7816-436f-8742-98bb836d82fd","added_by":"auto","created_at":"2026-03-03 09:57:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":843331,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8775750/v1/205faa77-c4dc-4d9f-95a5-04b2a9e9faac.pdf"},{"id":103399971,"identity":"d71c073c-86a1-4eea-bbee-1666bce1b875","added_by":"auto","created_at":"2026-02-25 09:13:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":243127,"visible":true,"origin":"","legend":"","description":"","filename":"CONSORTChecklist.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8775750/v1/706c8a7efc2aeb6390d9ccef.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Application of a Closed-Loop Target-Controlled Infusion System Guided by Multimodal Brain Monitoring in Colorectal Cancer Surgery","fulltext":[{"header":"Introduction","content":"\u003cp\u003eRadical resection of colorectal cancer under general anesthesia is the preferred treatment method for this disease\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Factors such as prolonged operative time, excessive intraoperative blood loss, and propofol overdose can lead to intraoperative hypotension in patients\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Hypotension increases the risk of intraoperative mortality in colorectal cancer patients. Therefore, precise regulation of anesthetic medications is crucial\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTraditional intraoperative anesthesia management relies primarily on anesthesiologists manually adjusting parameters on the basis of limited monitoring indicators and clinical experience. During surgery, a patient's physiological state can change rapidly, and monitoring a single parameter often fails to comprehensively reflect the depth of anesthesia and analgesia. This leads to risks such as intraoperative awareness or excessive anesthesia depth\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Modern clinical anesthesia is evolving toward greater precision and individualization. Advances in monitoring technologies have enabled precise intraoperative drug administration\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Recently, multimodal physiological data monitoring and intelligent closed-loop control have gained increasing attention: by integrating multiple vital signs, such as electroencephalogram (EEG), cerebral oxygenation (rSO₂), and hemodynamics, these approaches achieve a more comprehensive perception of the patient's anesthetic state \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe closed-loop target-controlled system guided by multimodal brain function monitoring comprises noninvasive EEG sensors, TCI pumps, vital sign monitors, anesthesia depth monitors, an intelligent integrated hub, and a surgical anesthesia information system. The anesthesia depth monitor collects frontal lobe EEG signals via noninvasive sensors. Wavelet algorithms decompose these signals into cortical and subcortical components, extracting functional indices such as the wavelet index (WLi), pain threshold index (PTi), and cognitive index (Cogi). Vital sign monitoring uses a cerebral oxygenation module to collect cerebral oxygen saturation alongside vital parameters such as heart rate and blood pressure. The intelligent control center receives and processes these monitoring data to dynamically adjust the TCI target-controlled infusion rate. This study investigated the clinical efficacy of a closed-loop target-controlled system guided by multimodal brain function monitoring for general anesthesia in colorectal surgery patients.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Patients\u003c/h2\u003e \u003cp\u003eThis study is a randomized controlled trial. This study was approved by the Research and Clinical Trial Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No. 2021-KY-1106-002) and registered with the China Clinical Trial Registry (Registration No. ChiCTR2100049859). All patients provided written informed consent. Patients who underwent laparoscopic radical resection for colorectal cancer at the First Affiliated Hospital of Zhengzhou University between June 2022 and December 2024 were selected. The inclusion criteria were as follows: age\u0026thinsp;\u0026ge;\u0026thinsp;18 years and American Society of Anesthesiologists (ASA) physical status I\u0026ndash;II. The exclusion criteria were as follows: preoperative coagulation abnormalities; preoperative atelectasis, pulmonary bullae, or severe chronic obstructive pulmonary disease; severe systemic diseases (cardiac, hepatic, renal, etc.) prior to surgery; and preoperative psychiatric disorders or prolonged use of psychotropic medications. A total of 100 patients were enrolled and randomly assigned via a random number table to either the closed-loop target-controlled infusion group (Group A) or the manually adjusted infusion group (Group B) (Fig.\u0026nbsp;1).\u003c/p\u003e \u003cp\u003ePatients were randomly divided into two groups using a random number table method. An independent statistician prepared sequentially numbered, opaque, and sealed envelopes containing group allocation information, which were stored in the operating room. After confirming that the patient met the inclusion criteria and obtaining written informed consent, a designated anesthesiologist (who was not involved in patient recruitment, data collection, or analysis) opened the envelope, thereby ensuring allocation concealment. All experimental equipment used the same manufacturer and model to ensure blinding of patients, surgeons, and outcome assessors. Data collectors were professionally trained, did not participate in anesthesia administration, and were unaware of group allocation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Anesthesia methods\u003c/h2\u003e \u003cp\u003eAll patients were instructed to fast and abstain from drinking water prior to surgery. Preoperatively, peripheral venous access was established, oxygen therapy was initiated, and patients were connected to cardiac monitoring and a total depth of anesthesia monitoring. Noninvasive EEG sensors and cerebral oximetry probes were properly applied. Under local anesthesia, radial artery catheterization and right internal jugular vein catheterization were performed. After 3 minutes of oxygen administration, Group A received propofol with an initial target plasma concentration of 1.5 \u0026micro;g/ml, which was increased by 0.5\u0026micro; g/ml every 2 minutes. Group B received 2\u0026thinsp;~\u0026thinsp;4 mg/kg propofol. Consciousness levels were continuously monitored in both groups until loss of consciousness occurred. Subsequently, intravenous boluses of alfentanil (50 \u0026micro;g/kg) and rocuronium bromide (0.6 mg/kg) were administered. Tracheal intubation was performed after neuromuscular blockade was effective. During the maintenance phase, remifentanil infusion was initiated. Group A had a target plasma concentration of 3 ng/mL for remifentanil, whereas Group B had a remifentanil infusion rate of 0.05\u0026thinsp;~\u0026thinsp;2 \u0026micro;g/kg/min. Both groups set target values for WLi and PTi at 40\u0026thinsp;~\u0026thinsp;60. In Group A, the target-controlled system automatically adjusted the target TCI concentration on the basis of WLi and PTi, dynamically regulating the propofol and remifentanil infusion rates. In Group B, anesthesiologists manually adjusted the propofol and remifentanil infusion rates according to the monitored indicators to maintain WLi and PTi at the same target values. When the MAP is \u0026lt;\u0026thinsp;65 mmHg or the SBP is \u0026lt;\u0026thinsp;90 mmHg, an intravenous bolus or pump infusion of 8 \u0026micro;g/ml norepinephrine is administered. When rSO₂ decreased\u0026thinsp;\u0026ge;\u0026thinsp;20% from baseline or absolute rSO₂ \u0026le;50% persisted for \u0026gt;\u0026thinsp;3 minutes, cerebral perfusion and oxygenation were maintained through neuroprotective measures, including timely application of ice caps, increased oxygen concentration, ventilator parameter adjustments, and maintenance of blood pressure and CO₂ within normal ranges. Both groups underwent volume-controlled ventilation with the tidal volume set at 6\u0026ndash;8 mL/kg, an inspiratory-to-expiratory ratio of 1:2, an oxygen flow rate of 2 L/min, and an appropriately adjusted respiratory rate to maintain the P\u003csub\u003eET\u003c/sub\u003eCO₂ at 35\u0026thinsp;~\u0026thinsp;45 mmHg. Rocuronium bromide (0.15 mg/kg) was intermittently administered as needed.\u003c/p\u003e \u003cp\u003eAll patients underwent surgery by the same team of skilled surgeons, with identical laparoscopic incisions and intraoperative CO₂ insufflation pressures maintained at 12 mmHg. At the conclusion of skin closure, the infusion of remifentanil and propofol was discontinued, followed by intravenous bolus administration of 5 mg dexmedetomidine and 0.25 mg palonosetron. Following surgery, patients were transferred to the PACU. After the patient regained consciousness, the endotracheal tube was removed. Patients were discharged back to their ward once their Aldert nursing score reached 10 points.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Data collection\u003c/h2\u003e \u003cp\u003eThis study primarily collected clinical data from patients with colorectal cancer, including age, sex, height, weight, BMI, ASA classification, preoperative hemoglobin, creatinine levels, surgical procedure type, preincision lactate levels, operative duration, anesthesia duration, total fluid administration, blood loss, urine output, HR, SBP, DBP, MAP and rSO\u003csub\u003e2\u003c/sub\u003e at various intraoperative time points, intraoperative propofol and remifentanil dosages, intraoperative norepinephrine dosage, postoperative hemoglobin, postoperative creatinine, lactate levels upon PACU admission, postoperative extubation time, PACU duration, hospital stay, intraoperative awareness and complications within 7 days post-operatively. During surgery, the patient's heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and relative oxygen saturation (rSO₂) values must be recorded at specific time points: before anesthesia induction (T\u003csub\u003e0\u003c/sub\u003e), 5 minutes after anesthesia induction (T\u003csub\u003e1\u003c/sub\u003e), at the start of surgery (T\u003csub\u003e2\u003c/sub\u003e), 1 hour after surgery commencement (T\u003csub\u003e3\u003c/sub\u003e), and at the conclusion of surgery (T\u003csub\u003e4\u003c/sub\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Definitions\u003c/h2\u003e \u003cp\u003ePostoperative complications include pneumonia, acute kidney injury, postoperative delirium, wound infection, and urinary tract infection. Acute kidney injury is defined as an increase in serum creatinine levels exceeding 26.4 \u0026micro;mol/L within 48 hours \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Postoperative delirium is assessed via the CAM scale \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Statistical analysis\u003c/h2\u003e \u003cp\u003eSample size estimation was performed via PASS 2021. On the basis of pretrial results, we projected a minimum 8% reduction in propofol usage in the automated closed-loop target-controlled infusion group. With a significance level of α\u0026thinsp;=\u0026thinsp;0.05, 1-β\u0026thinsp;=\u0026thinsp;0.8, and a 20% dropout rate, the sample size calculation indicated a minimum of 40 subjects per group. Therefore, this study enrolled 100 subjects on the basis of the estimated sample size.\u003c/p\u003e \u003cp\u003eData analysis was performed via SPSS 23.0 software. Normally distributed continuous data are presented as the means\u0026thinsp;\u0026plusmn;\u0026thinsp;SDs, and intergroup comparisons were conducted via independent samples t tests. Nonnormally distributed continuous data are presented as M (P25, P75). Intergroup comparisons were performed via the Mann‒Whitney U test, whereas intragroup comparisons at different time points were analyzed via repeated-measures ANOVA. Categorical data are expressed as cases (%). Intergroup comparisons were conducted via the chi-square test or Fisher's exact test. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThis study included 100 patients. Group A (the experimental group) received anesthesia guided by a closed-loop target-controlled system via multimodal brain function monitoring, whereas Group B (the control group) received anesthesia with manually adjusted drug dosages. Each group comprised 50 patients. First, basic patient characteristics were compared between groups. No significant differences were observed in age, sex, weight, height, BMI, ASA classification, or surgical type (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Second, no statistically significant differences in preoperative hemoglobin, preoperative creatinine, preoperative lactate, duration of surgery, duration of anesthesia, total fluid administration, blood loss, or urine output (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) were detected between the groups, as shown in Table\u0026nbsp;2. Compared with Group B patients, Group A patients required a reduced propofol dosage (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and decreased norepinephrine usage (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Lactate levels upon PACU admission were significantly lower in Group A than in Group B (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Compared with Group B patients, Group A patients had significantly shorter extubation times and PACU stay durations (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There were no statistically significant differences between the two groups in terms of intraoperative remifentanil dosage, postoperative hemoglobin levels, creatinine levels, or length of hospital stay (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;2. Within-group comparisons revealed that HR values at T\u003csub\u003e0\u003c/sub\u003e were significantly greater than those at subsequent time points (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Compared with those at T\u003csub\u003e0\u003c/sub\u003e, SBP, DBP, MAP, and rSO₂ at T1 were significantly lower in both groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At T\u003csub\u003e2\u003c/sub\u003e, SBP, DBP, MAP, and rSO₂ were significantly elevated compared with those at T1 (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The T\u003csub\u003e3\u003c/sub\u003e values decreased significantly compared with those in T\u003csub\u003e2\u003c/sub\u003e (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Intergroup comparisons revealed no significant differences in HR at any time point between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). At T\u003csub\u003e1\u003c/sub\u003e, the DBP of Group A was significantly greater than that of Group B (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), whereas no statistically significant differences in DBP were detected at other time points (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). At T\u003csub\u003e1\u003c/sub\u003e and T\u003csub\u003e3\u003c/sub\u003e, Group A\u0026apos;s SBP, MAP, and rSO₂ were significantly greater than those of Group B (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At other time points, no statistically significant differences were observed in SBP, MAP, or rSO₂ between the groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e indicates that no intraoperative awareness occurred in either group. There were no statistically significant differences between the two groups in terms of the incidence of postoperative delirium, pneumonia, postoperative nausea and vomiting, acute kidney injury, or urinary tract infection (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWith the advancement of personalized anesthesia concepts, \u0026ldquo;precision anesthesia\u0026rdquo; has become the goal of modern anesthesia management. Its key lies in real-time adjustment of anesthesia depth on the basis of patient variability and surgical characteristics, ensuring that surgical requirements are met while maximizing protection of brain function and vital organ perfusion\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. Precision intraoperative drug administration, monitoring, and management are essential components of precision anesthesia. By precisely controlling anesthetic drug dosage and timing, patient surgical experience and postoperative recovery quality can be significantly enhanced\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn precision anesthesia management, a single parameter often fails to comprehensively reflect the complex state of brain function. A multimodal neural monitoring approach that combines electroencephalography (EEG) with near infrared spectroscopy (NIRS) offers a more comprehensive solution for precision anesthesia management\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. EEG provides dynamic information on anesthesia depth and central nervous system function, reflecting the degree of drug-induced suppression of brain electrical activity. Brain oxygen monitoring, which is based on near-infrared spectroscopy (NIRS) principles, enables real-time, continuous assessment of the oxygenation status of local brain tissue. Superficial and deep detection via forehead probes reflect subcutaneous and cortical oxygenation levels, respectively. Continuous monitoring of regional brain oxygen saturation (rSO₂) assists anesthesiologists in the early identification of cerebral hypoperfusion or systemic hypoxia risk\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAnesthetic induction often causes large numbers of neurons to be synchronously inhibited, resulting in regular and slow brain rhythms and a subsequent decrease in the sedation index. This state of low sedation corresponds to loss of consciousness and sensory isolation, which are typical manifestations of anesthetic effects. However, if excessive anesthesia leads to prolonged burst suppression, the EEG will exhibit alternating periods of flatline and high-amplitude bursts accompanied by a marked decrease in rSO₂. This phenomenon is often interpreted as a sign of severe suppression of brain function or even impending danger\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Excessive anesthesia depth is closely associated with the occurrence of postoperative delirium (POD) \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, and the incidence of postoperative delirium in patients over 65 years of age can reach as high as 50%\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Currently, the bispectral index (BIS) is the most widely used tool for monitoring anesthesia depth in clinical settings, whereas wavelet algorithms represent a technological innovation in neurophysiological monitoring. For the vast majority of nonstationary signals (such as EEG signals), the wavelet algorithm employing wavelet exponents is more suitable than the Fourier transform used in BIS, as it effectively mitigates the influence of analgesia and muscle relaxation levels on sedation depth\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. The incidence of intraoperative awareness in patients was 0% in this study. This further demonstrates the safety of EEG wavelet monitoring technology. Compared with the manual control group, the closed-loop target-control group used less propofol during surgery, with an average reduction of 10 mg (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01); had shorter postoperative recovery times, with an average reduction of 3 minutes (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05); and spent less time in the PACU, with an average reduction of 10 minutes (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). There was no significant difference in the rSO₂ between the two groups prior to anesthesia induction (T\u003csub\u003e0\u003c/sub\u003e) (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating that both groups had identical baseline cerebral oxygenation states. The closed-loop target-controlled group showed a significant decrease in the rSO₂ only at 5 minutes after the induction of anesthesia (T\u003csub\u003e1\u003c/sub\u003e) (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with no significant decrease at other time points (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The manual control group presented a significant downward trend in rSO₂ at both T\u003csub\u003e1\u003c/sub\u003e and T\u003csub\u003e3\u003c/sub\u003e (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At both T\u003csub\u003e1\u003c/sub\u003e and T\u003csub\u003e3\u003c/sub\u003e, the rSO₂ in the closed-loop target-control group was significantly greater than that in the manual control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). These results indicate that the closed-loop target-controlled group experienced a smaller decrease in rSO₂ relative to baseline and a more stable trend during both the induction and maintenance of anesthesia. Additionally, the incidence of postoperative delirium (POD) in both groups was lower than that reported in previous studies\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e (4%~10% vs. 11.1%~50%), with fewer cases occurring in the closed-loop target-controlled group (2 vs. 5). These findings indicate that combined intraoperative EEG and rSO₂ monitoring optimizes the anesthetic depth and balance between the brain oxygen supply and demand, thereby reducing the sedative dosage and lowering the incidence of postoperative delirium and cognitive impairment. Precise closed-loop target control maintains more stable rSO₂ indices, which holds significant value for improving patients' short-term outcomes.\u003c/p\u003e \u003cp\u003ePrecision anesthesia management focuses not only on monitoring the central nervous system but also on prioritizing perfusion and protection of vital organs throughout the body. Intraoperative hemodynamic monitoring is central to achieving this goal, with the key objective being to maintain appropriate perfusion pressure and tissue oxygenation to ensure that the metabolic demands of vital organs are met\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. The mean arterial pressure (MAP) is one of the most important clinical indicators in hemodynamic monitoring\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. Patients with colorectal cancer experience significant intraoperative blood and fluid loss, which may impair the self-regulatory capacity of the brain, heart, and kidneys. This leads to heightened sensitivity of these organs to hypoperfusion. Numerous studies have demonstrated that maintaining an intraoperative mean arterial pressure (MAP)\u0026thinsp;\u0026ge;\u0026thinsp;65 mmHg reduces the incidence of perioperative complications\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. In this study, sedation and analgesia indices were continuously monitored in the closed-loop target-controlled group (Group A), the values were compared against the target values, deviations were calculated, and the infusion rates of propofol and remifentanil were adjusted accordingly. The results revealed no significant difference in the baseline MAP values between the experimental group and the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The MAP value in the closed-loop target-control group significantly decreased only at 5 minutes after the induction of anesthesia (T\u003csub\u003e1\u003c/sub\u003e) (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At all other time points, the MAP value did not significantly decrease (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The MAP values in the control group decreased significantly at T\u003csub\u003e3\u003c/sub\u003e, T\u003csub\u003e4\u003c/sub\u003e, and \u003cem\u003eT5 (P\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At time point T\u003csub\u003e1\u003c/sub\u003e, the MAP value in the experimental group was significantly greater than that in the control \u003cem\u003egroup (P\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Compared with those in the control group, patients in the closed-loop target-controlled infusion group (Group A) had significantly lower norepinephrine dosages, with an average decrease of approximately 16 \u0026micro;g (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Postoperative blood lactate levels in Group A were significantly lower than those in Group B (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The results fully demonstrate that the use of a closed-loop target-controlled anesthesia system guided by multimodal brain function monitoring during general anesthesia reduces the incidence of intraoperative hypotension in patients, decreases the dosage of vasoactive drugs, and thereby better maintains organ perfusion.\u003c/p\u003e \u003cp\u003eThis study also has several limitations. First, to ensure surgical safety, manual intervention was required to maintain normal parameters when WLi and PTi values exceeded 60 and persisted for more than 3 minutes. Second, the closed-loop target-controlled system lacks the capacity to handle complex situations. When dangerous conditions such as massive intraoperative bleeding occur, anesthesiologists must promptly resolve the issue. Finally, the selection of surgical procedures in this study was limited. Further research is needed to determine whether different types of surgery influence the study outcomes.\u003c/p\u003e \u003cp\u003eIn summary, this study employs target-controlled infusion technology to precisely regulate anesthetic effects, utilizes brain wavelet index monitoring to assess sedation depth and prevent anesthetic overdose or underdose, employs injury sensitivity index monitoring to guide rational analgesic drug administration, and employs brain oxygen level monitoring to evaluate cerebral tissue oxygen supply. This approach facilitates a transition from traditional experience-based management to a new phase guided by neurological function. Simultaneously, the closed-loop target-controlled system guided by multimodal brain function monitoring reduces the number of repetitive tasks for anesthesiologists, enabling them to focus more on addressing critical challenges during surgery and enhancing medical efficiency and safety. Multimodal data fusion (integrating signals such as heart rate variability, pupil monitoring, and facial electromyography) will lead to more comprehensive patient status assessments and smarter system decision-making. Its clinical application is expected to expand beyond colorectal surgery into more complex fields, such as cardiac and neurosurgical fields\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Abbreviations","content":" \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAbbreviations\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eThe full term or phrase\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eWLi\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eThe wavelet index\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePTi\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003epain threshold index\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eSBP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003esystolic blood pressure\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDBP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ediastolic blood pressure\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMAP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003emean arterial pressure\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eHR\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eheart rate\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003erSO\u003csub\u003e2\u003c/sub\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eregional oxygen saturation\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePACU\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003epostanaesthesia care unit\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eEEG\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eelectroencephalogram\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eCogi\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ecognitive index\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eASA\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAmerican Society of Anesthesiologists\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eNIRS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003enear infrared spectroscopy\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePOD\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003epostoperative delirium\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eBIS\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ethe bispectral index\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Scientific Research and Clinical Trials Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No.2021-KY-1106-002), registered in the China Clinical Trial Registry (Registration No.ChiCTR2100049859). All patients provided written informed consent.This study adhered to the guidelines established by the Consolidated Standards of Reporting Trials (CONSORT) and complied with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and/or analyzed during the current study are not publicly available due to privacy requirements but are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Henan Provincial Science and Technology Research Project (2018010006).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contributions\u003c/strong\u003e :\u003c/p\u003e\n\u003cp\u003eStudy design: SH, ZZ, ZS. Study conduct: SH, ZZ, ZS. Data analysis:SH. Writing paper: SH, ZZ, ZS. All authors read and approved the final manuscript version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely appreciate the invaluable contributions of all participants, without whom this research would not have been possible.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLi M, Hu J, Suo L, et al. Efficacy of laparoscopic radical resection of right-sided colon cancer by different surgical approaches: network-meta-analysis[J]. BMC Surg. 2024;24(1):347.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNguyen NT. Wolfe BM.The physiologic effects of pneumoperitoneum in the morbidly obese[J]. Ann Surg 2005,241(2):219\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGregory A, Stapelfeldt WH, Khanna AK et al. Intraoperative Hypotension Is Associated With Adverse Clinical Outcomes After Noncardiac Surgery[J].Anesth Analg,2021,132(6):1654\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaferri\u0026egrave;re-Langlois P, Morisson L, Jeffries S et al. Depth of Anesthesia and Nociception Monitoring: Current State and Vision For 2050[J].Anesth Analg,2024,138(2):295\u0026ndash;307.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerger-Estilita J. Marcolino I,Radtke FM.Patient-centered precision care in anesthesia - the PC-square (PC) 2 approach[J]. Curr Opin Anesthesiol. 2024;37(2):163\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMomeni M, Meyer S, Docquier MA, et al. Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions[J]. J Clin Monit Comput. 2019;33(6):999\u0026ndash;1009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhwaja A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract 2012,120(4):c179\u0026ndash;184.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan Rompaey B, Schuurmans MJ, Shortridge-Baggett LM et al. A comparison of the CAM-ICU and the NEECHAM Confusion Scale in intensive care delirium assessment: an observational study in nonintubated patients[J].Crit Care,2008,12(1):R16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuo FH, Tudor BH, Gray GM et al. Precision Anesthesia in 2050[J].Anesth Analg,2024,138(2):326\u0026ndash;336.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHung MH. Chen JS,Cheng YJ.Precise anesthesia in thoracoscopic operations[J]. Curr Opin Anesthesiol. 2019;32(1):39\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagoon RP. Cardiac Anesthesia: Welcome Aboard![J].J Cardiothorac Vasc Anesth,2020,34(9):2551\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGandee R, Miller CM. Monitoring: Toward Improved Outcomes[J].Semin Respir Crit Care Med,2017,38(6):785\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGomez A, Sainbhi AS, Froese L et al. Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions[J].Front Pharmacol,2021,12:719501.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePellicer A, de Boode W, Dempsey E, et al. Cerebral near-infrared spectroscopy guided neonatal intensive care management. for the preterm infant[J].Pediatr Res; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones KG, Lybbert C, Euler MJ, et al. Diversity of electroencephalographic patterns during propofol-induced burst suppression[J]. Front Syst Neurosci. 2023;17:1172856.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSwarbrick CJ. Partridge JSL.Evidence-based strategies to reduce the incidence of postoperative delirium: a narrative review[J].Anesthesia,2022,77 Suppl 1:92\u0026ndash;101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUrb\u0026aacute;nek L. Urb\u0026aacute;nkov\u0026aacute; P,Satinsk\u0026yacute; I. Postoperative delirium[J] Rozhl Chir 2023,102(10):381\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang XT, Cheng H, Xiong W et al. Comparison of the ability of wavelet index and bispectral index for reflecting regain of consciousness in patients undergone surgery[J]. Chin Med J (Engl) 2010,123(12):1520\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKent CD. Domino KB.Depth of anesthesia[J]. Curr Opin Anesthesiol. 2009;22(6):782\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJanssen TL, Steyerberg EW, Faes MC, et al. Risk factors for postoperative delirium after elective major abdominal surgery in elderly patients: A cohort study[J]. Int J Surg. 2019;71:29\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoullis M. Perfusion and aortic surgery: patient directed cardiopulmonary bypass and quality improvement[J]. J Extra Corpor Technol 2011,43(1):P68\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIngelmo P. Barone M,Fumagalli R.Importance of monitoring in high risk surgical patients[J]. Minerva Anestesiol 2002,68(4):226\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBergholz AGr\u0026uuml;\u0026szlig;erL, Khader WTAK, et al. Personalized perioperative blood pressure management in patients having major noncardiac surgery: A bicentric pilot randomized trial[J]. J Clin Anesth. 2025;100:111687.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLopes S, Rocha G. Artificial intelligence and its clinical application in Anesthesiology: a systematic review[J]. J Clin Monit Comput. 2024;38(2):247\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTABLE 1 Comparison of basic patient information\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eGroup A（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eGroup B（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003et/\u003c/em\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e58.06\u0026plusmn;12.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e59.58\u0026plusmn;11.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eGender（Male/Female）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e30/20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e31/19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eWeight（kg）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e67.42\u0026plusmn;10.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e65.73\u0026plusmn;10.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.800\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.462\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eHeight（cm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e166.66\u0026plusmn;8.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e165.86\u0026plusmn;7.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.611\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e24.21\u0026plusmn;2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e23.81\u0026plusmn;3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.671\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eASA Classification（Ⅱ/Ⅲ cases）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8/42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e7/43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.779\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eTypes of Surgery\u003c/p\u003e\n \u003cp\u003eRadical Resection for Colorectal Cancer/Rectal Cancer（cases）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20/30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14/36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.604\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 550px;\"\u003e\n \u003cp\u003eBMI, Body Mass Index; ASA Classification, American society of Aneshesiologists (ASA) physical status classification system; Types of Surgery include radical resection for colorectal cancer and radical resection for rectal cancer.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTABLE 2 \u0026nbsp;Comparison of important clinical data related to surgery\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eGroup A（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003eGroup B（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003et/Z\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePreoperative Hemoglobin（g/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e126.56\u0026plusmn;20.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e128.14\u0026plusmn;20.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.386\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.700\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePreoperative serum\u003c/p\u003e\n \u003cp\u003ecreatinine（mmol/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67.31\u0026plusmn;13.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e64.88\u0026plusmn;17.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.779\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.438\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePreoperative blood\u003c/p\u003e\n \u003cp\u003elactate（mmol/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.86\u0026plusmn;0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.74\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eDuration of surgery（min）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e197.34\u0026plusmn;58.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e216.18\u0026plusmn;57.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.624\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eDuration of anesthesia（min）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e232.04\u0026plusmn;64.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e249.80\u0026plusmn;69.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eTotal fluid intake（ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2429.00\u0026plusmn;448.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2460.60\u0026plusmn;479.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.341\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.734\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eBlood loss（ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e111.00\u0026plusmn;60.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e122.00\u0026plusmn;62.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.374\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eUrine output（ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e625.00\u0026plusmn;343.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e565.50\u0026plusmn;370.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.407\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eRemifentanil dosage（mg）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2.43\u0026plusmn;0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2.76\u0026plusmn;0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePropofol dosage（mg）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e38.92\u0026plusmn;13.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e48.51\u0026plusmn;15.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eNorepinephrine dosage (mg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0(0,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e16(0,32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePostoperative blood lactate (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.70(0.50,1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.75(0.60,1.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePostoperative hemoglobin（g/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e116.02\u0026plusmn;17.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e114.96\u0026plusmn;17.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePostoperative creatinine\u003c/p\u003e\n \u003cp\u003e（mmol/L）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e67.71\u0026plusmn;15.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e67.34\u0026plusmn;19.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.918\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eExtubation time（min）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e18(16,21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e21(17,34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003ePACU Stay Duration（min）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e50(40,62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e60(53,67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eLength of hospital stay（days）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e9(7,10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e8(7,11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTABLE 3 Intragroup and intergroup comparisons of HR, SBP, DBP, MAP, and rSO₂\u0026nbsp;at different time points\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"107%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 52px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 52px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 101px;\"\u003e\n \u003cp\u003eHR(次/分)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003eT\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e71.12\u0026plusmn;13.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e66.36\u0026plusmn;12.37\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e58.08\u0026plusmn;8.16\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e59.10\u0026plusmn;9.70\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e59.76\u0026plusmn;9.20\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e10.960\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e71.58\u0026plusmn;13.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e65.24\u0026plusmn;11.66\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e59.76\u0026plusmn;9.52\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e62.74\u0026plusmn;10.12\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e65.54\u0026plusmn;11.66\u003csup\u003eac\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e11.321\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0.898\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e3.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e7.569\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eSBP(mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003eT\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e137.00\u0026plusmn;14.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e123.40\u0026plusmn;14.24\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e140.66\u0026plusmn;13.09\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e126.64\u0026plusmn;14.05\u003csup\u003eac\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e128.00\u0026plusmn;15.87\u003csup\u003eac\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e14.728\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e136.90\u0026plusmn;18.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e108.78\u0026plusmn;16.07\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e137.74\u0026plusmn;19.68\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e119.76\u0026plusmn;13.70\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e124.96\u0026plusmn;19.91\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e52.077\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e23.183\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e6.147\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eDBP(mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003eT\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e75.94\u0026plusmn;10.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e68.84\u0026plusmn;9.91\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e79.66\u0026plusmn;12.42\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e73.28\u0026plusmn;10.36\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e70.34\u0026plusmn;10.91\u003csup\u003eac\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e9.420\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e75.12\u0026plusmn;11.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e61.74\u0026plusmn;9.67\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e79.52\u0026plusmn;17.13\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e70.86\u0026plusmn;11.45\u003csup\u003ebc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e67.88\u0026plusmn;12.91\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e28.472\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e13.149\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e1.228\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eMAP(mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003eT\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e97.24\u0026plusmn;10.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e88.40\u0026plusmn;10.08\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e102.06\u0026plusmn;13.18\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e92.30\u0026plusmn;11.80\u003csup\u003ebc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e92.40\u0026plusmn;12.41\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e12.721\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e96.92\u0026plusmn;9.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e77.70\u0026plusmn;9.32\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e102.08\u0026plusmn;16.84\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e87.26\u0026plusmn;12.44\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e90.06\u0026plusmn;17.10\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e50.564\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e30.388\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e4.322\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003erSO\u003csub\u003e2\u003c/sub\u003e（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003eT\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003eT\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e64.41\u0026plusmn;2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e62.62\u0026plusmn;2.88\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e64.42\u0026plusmn;2.77\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e63.75\u0026plusmn;3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e65.30\u0026plusmn;3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e9.075\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e64.56\u0026plusmn;3.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e59.00\u0026plusmn;3.34\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e63.72\u0026plusmn;2.96\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e61.50\u0026plusmn;4.31\u003csup\u003eabc\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e63.62\u0026plusmn;3.80\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e60.584\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e33.688\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1.473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e8.394\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5.235\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e*P\u0026lt;0.05\u003csup\u003e, **P\u0026lt;0.01;\u003c/sup\u003e\u003csup\u003e与\u003c/sup\u003e\u003csup\u003eT0\u003c/sup\u003e\u003csup\u003e时比较\u003c/sup\u003e\u003csup\u003e, aP\u003c/sup\u003e\u0026lt;0.05;与T\u003csub\u003e1\u003c/sub\u003e时比较, \u003csup\u003eb\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05;与T\u003csub\u003e2\u003c/sub\u003e时比较\u003cem\u003e,\u003c/em\u003e\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003ecP\u003c/sup\u003e\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003eTABLE 4 Comparison of intraoperative adverse events and postoperative complications in patients\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eGroup A（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eGroup B（N=50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cem\u003ec\u003c/em\u003e\u003cem\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e值\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eIntraoperative awareness（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0(0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0(0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003ePneumonia（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e2(4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e1.382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.240\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eAcute Kidney Injury（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e0(0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1(2.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e1.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003ePostoperative delirium（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e2(4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.433\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003ePostoperative nausea and vomiting（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4(8.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.727\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003eInfection of the Wound（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e1(2.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3(6.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 41px;\"\u003e\n \u003cp\u003e1.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Precision Anesthesia, Multimodal Brain Monitoring, The Closed-Loop Target-Controlled Infusion System, Hypotension, Postoperative delirium","lastPublishedDoi":"10.21203/rs.3.rs-8775750/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8775750/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEvaluating the Safety and Superiority of a Closed-Loop Target-Controlled System Guided by Multimodal Brain Function Monitoring in Colorectal Surgery Patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients who underwent radical resection for colorectal cancer under general anesthesia were randomly assigned to either the closed-loop target-controlled group (Group A) or the manual adjustment group (Group B). In Group A, anesthesia induction and maintenance were achieved by automatically adjusting the infusion rates of remifentanil and propofol via the closed-loop target-controlled system. Group B underwent anesthesia induction and maintenance through manual adjustment. The target range for the wavelet index (WLi) and pain threshold index (PTi) was set at 40 ~ 60 for both groups. The following parameters were recorded: patient demographics and surgical indicators; intraoperative propofol and remifentanil dosages; systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and regional oxygen saturation (rSO\u003csub\u003e2\u003c/sub\u003e) at various time points; intraoperative norepinephrine dosage; preoperative and postoperative hemoglobin, creatinine, and lactate levels; extubation time; postanaesthesia care unit (PACU) stay duration; and length of hospital stay; and the occurrence of intraoperative awareness and postoperative complications within 7 days.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCompared with Group B patients, Group A patients had significantly lower intraoperative propofol consumption (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05); the intraoperative norepinephrine dosage and lactate levels upon PACU admission were significantly lower in Group A patients than in Group B patients (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05); and Group A patients presented more stable perioperative mean arterial pressure (MAP) and regional oxygen saturation (rSO₂). Compared with Group B patients, Group A patients had significantly shorter extubation times and PACU stay durations (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05). However, no statistically significant differences were observed between the two groups in terms of hospital stay duration, intraoperative awareness, or postoperative complications within 7 days (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCompared with manual adjustment, closed-loop target-controlled systems guided by multimodal brain function monitoring offer more benefits for patients undergoing colorectal surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial Registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Scientific Research and Clinical Trials Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Approval No.2021-KY-1106-002), registered in the China Clinical Trial Registry (Registration No.ChiCTR2100049859,registration date on 08/10/2021).\u003c/p\u003e","manuscriptTitle":"The Application of a Closed-Loop Target-Controlled Infusion System Guided by Multimodal Brain Monitoring in Colorectal Cancer Surgery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-25 09:12:08","doi":"10.21203/rs.3.rs-8775750/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d1a4247f-9d2c-489d-be9a-0b2afd5a7c06","owner":[],"postedDate":"February 25th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-03T09:56:34+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-25 09:12:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8775750","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8775750","identity":"rs-8775750","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}