To investigate the optimizing effect of the propofol-remifentanil closed-loop feedback target-controlled infusion (TCI) system on body movement responses and surgical field clarity during painless gastrointestinal endoscopy.

A total of 120 patients scheduled for painless gastrointestinal endoscopy in XD Group Hospital between July 2023 and July 2024 were selected as the research subjects and randomly divided into an observation group and a control group, with 60 cases in each group. The control group received anesthesia using a conventional TCI system, while the observation group was anesthetized with a propofol-remifentanil closed-loop feedback TCI system. The incidence of body movement, clarity of the surgical field, anesthetic drug consumption, awakening time, and adverse reactions were compared between the two groups.

The total incidence of body movement in the observation group was significantly lower than that in the control group (8.33% vs. 28.33%), and the rate of excellent or good surgical field clarity was 96.67% in the observation group, significantly higher than 81.67% in the control group, with significantly significant differences (P<0.05). The dosages of propofol and remifentanil, as well as the awakening time, were significantly reduced in the observation group compared with the control group (P<0.05). The incidence of adverse reactions (hypotension, respiratory depression and nausea and vomiting) was also significantly lower in the observation group (P<0.05).

The propofol-remifentanil closed-loop feedback TCI system can effectively reduce body movement responses, enhance surgical field clarity, decrease anesthetic drug usage and the risk of adverse reactions.