Abstract: Objective To observe the clinical effects of the joint BIS monitoring and etomidate,remifentanil,cis-atracurium total intravenous anesthesia on general anesthesia in elderly patients. Methods Thirty cases required general anesthesia for elective ultra elderly critically ill patients were randomly divided into group A and group B by using a random number table,15 cases in each group.Group A were induced analgesia slow endotracheal intubation with amnesia,group B with quick tracheal intubation.Record respectively before anesthesia induction(T₀),after induction(T₁),intubation immediate(T₂),after intubation 3 min(T₃),surgery(T₄) at the end of the two groups of patients with MAP,HR,SpO₂ and PETCO₂.Record two groups of patients after extubation agitation score,adverse reactions and dosage of anesthetics. Results Compare with before induction MAP,HR ison,group B at T1 decreases in T₂,T₃ point increased,the difference was statistically significant(P<0.05);Compare with group A MAP,HR group B at T₁ decrease in T₂,T₃ point increased,the difference was statistically significant(P<0.05).After surgery extubation restlessness score,the number of cases of adverse reactions in group A was significantly lower than group B,the difference was statistically significant(P<0.05);The dosage of etomidate and cis atracurium was reduced in group A than group B. The difference was statistically significant(P<0.05).Intraoperative each time SpO₂ and PETCO₂ difference has no statistically significant(P>0.05). Conclusion Joint BIS-induced amnesia and analgesia slow etomidate,remifentanil,cis atracurium total intravenous anesthesia can be safely and effectively used in very elderly patients.