The Effect Of Laparoscopic Cholecystomy On Plasma Atrial Natriuretic Polypeptide And Cortison And Thyroid-stimulating Hormone And Hemodynamics

Objective:To study the effect of laparoscopic cholecystomy on plasma atrial Natriuretic polypeptide(Anp), cortison(Cor), thyroid-stimulating hormone (Tsh) and hemodynamics , the measurements of arterial carbon dioxide tension (PaC02) , the end-tidal CO2 concentration (PETCO2) ?Methods: 16 adult patient ASA I undergoing laparoscopic cholecystomy(n=8,A) and cholecystomy(n=8,B) were enrolled in this study. All the patients received a general anesthesia. Five data points were used :1 prior to induction, 2 immediately after induction (or 5min before opening the abdomen ), 3 (l0min after abdominal insufflation or l0min after opening the abdomen), 4 ( 2min before dissection of the gallbladder), 5 ( 5min after extubation). Blood sample were drawn in given time intervals to determine the concentration of plasma ANP, COR, TSH by radioimmunoassay. Heart rate (HR), mean arterial pressure (MAP), the end-tidal CO2 concentration (PETCO2) , arterial 02 saturation were recorded at the same time.The radial artery was cannulated for arterial blood gas analysis and for direct monitoring of the arterial blood pressure.Results: There were no difference of MAP, HR, PaCO2, PETCO2, Sp02 in given time intervals between A and B (p>0.05). There weredifferences of ANP, COR, TSH in the given 3,4,5 time intervals between AandB(p<0.05).Compare to the given 1 time interval : in the A group ,there were no difference of MAP, HR, SpO2 (p>0.05), there were differences of PaCO2, TSH in the given 2 time interval, there were differences of PEiCO2A ANP in the given 3,4 time interval , there was difference of COR in the given 3 time interval(p<0.05). In the B group ,there was no difference of MAP, ffi,SpO2(p>0.05), there was no difference of COR in the given 2,3,4,5 time interval(p>0,05), there was difference of PaC02 in the given 5 time interval(p<0.05), there was difference of PETCO2 in the given 3,4,5 time interval(p<0.05), there was difference of TSH in the given 2,3,4time interval(p<0.05), there was difference of ANP in the given 4,5 time interval(p<0.05).Conclusion: The laparoscope cholecystectomy to neuroendocrine is slight, thus affecting pain slightly, recovering quickly, spreading widely.