Evaluation of Closed-loop TIVA Propofol, Sufentanil and Ketamine Guided by BIS Monitor

"Defined as: MAP \< 70% of baseline Change NIBP (noninvasive blood pressure) measuring interval from 3 minutes to 1 minute until resolution of the event.~1. Give 200 mL Fluid Bolus~2. If not successful, give ephedrine 5 mg bolus~3. Repeat from 1.) if even is not resolved after 3.)"

"Defined as: SBP \> 130% of baseline sustained for 2 readings Change NIBP (noninvasive blood pressure) measuring interval from 3 minutes to 1 minute until resolution of the event.~1.) Labetalol 5 mg IV will be administered"

"Defined as: Heart rate \< 45 beats/min~1.) Bolus of 0.2 mg glycopyrrolate"

"Defined as: Heart Rate \> 90 beats/min~1. If associated with normal NIBP (MAP \> 60 mmHg and SAP \< 140): give fluid bolus of 200 mL, repeat once if required. Look for bleeding and treat if required.~2. If associated with hypertension (SAB \> 140 mmHg): proceed with the management of the hypotention during maintenance protocol.~3. If associated with hypotension (MAP \< 60 mmHg): proceed with the management of the hypotnetion during maintenance protocol."

"Defined as: MAP \< 70 % of baseline Change NIBP measuring interval from 3 minutes to 1 minute until resolution of the event.~1. give a 200 ml fluid bolus (crystalloid).~2. If not successful, give ephedrine 5 mg bolus.~3. If not successful decrease volatile by 0.1 MAC.~4. Repeat from 1) if event is not resolved after step 3) for maximum of 2 iterations"

"Defined as: SBP \> 130% of baseline Change NIBP measuring interval from 3 minutes to 1 minute until resolution of the event.~1. increase Sevoflurane by 0.1 MAC~2. If not successful after 3 minutes (SBP \>130% of baseline), increase Sevoflurane again by 0.1 MAC. Maximum of 1.2 allowed.~3. If still not successful (SBP \>130% of baseline), Labetolol 5mg IV will be administered."

"Defined as: Heart Rate \< 45 beats/min~1.) Bolus of 0.2 mg glycopyrrolate"

"Defined as: Heart rate \> 90 beats/min~1. if associated with normal NIBP (MAP \> 70% of baseline and SBP \<130% of baseline) : give fluid bolus of 200 ml, repeat once if required. (look for bleeding and treat if required).~2. If associated with hypertension (SBP \>130% of baseline) : proceed with the management of the hypertension during maintenance protocol.~3. If associated with hypotension (MAP \< 70% of baseline) : proceed with the management of the hypotension during maintenance protocol."