Effects Of Inhalation Anesthetic Sevoflurane On Stress Response During Laparoscopic Cholecystectomy

Objective To investigate the effects of inhalation anestheticsevoflurane on hemodynamics and stress response during laparoscopiccholecystectomy.Methods Sixty patients with cholelithiasis or gallbladder polypusreceived laparoscopic cholecystectomy, age 30-60, ASA-I. The patientswere randomly divided into 3 groups, which were group of S,S-R,I. Beforeanesthetic of induction:midazolam 0.06mg/kg, disoprrofol 2mg/kg, fentanil1.5ug/kg. The 3-4ï¼…inhalation anesthetic sevoflurane was as themaintenance anesthetic of group of S. The 3-4ï¼…inhalation anestheticsevoflurane and remifentanil 2-4ng/ml was as the maintenance anestheticof group of S. The 1.5-2ï¼…inhalation anesthetic isoflurane andremifentanil 2-4ng/ml was as the maintenance anesthetic of group of I. Theheart rate(HR, bpm),mean arterial pressure(MAP, kPa)of patients wearrecorded before and after induction, five minutes after inhalationsevoflurane, after pneumoperitoneum, before and after operation. Thecortisol(COS ng/ml),atrial natriuretic factor(ANP pg/ml),adrenocorticotropic hormone(ACTH pg/ml) wear recorded before induction,after pneumoperitoneum and after operation and the time of sober.Results Compared to the value of HR on T₂, T₅ and T₁ in group S, it wasdecreased on T₁. The value of HR was increaser on T₄ than T₁ in group I.There was no difference in the value of HR in group S-R. In comparisonto the group I, the value of HR on markedly decreased in group S-R onT₅. The value of HR was decreased in group S-R, while compared group Sand S-R on T₁. In group S and S-R, compared to the value of MAP on T₅ andT₁, it was decreased on T₅. In comparison to the value of MAP on T₂ and T₁ in group I, it was increased on T₂. Compard to the group S,S-R, the valueof HR was increased in group I on T₂, but it was obviously increased onTS. Compared to the activity of Cos on M1 and M₂ in group S and S-R, itwas decreased on M₂. In comparison to the activity on M₃ and M₁ in groupI, it was increased obviously on M₃. Compared to the group S and I, theactivity of Cos was decreased in group S-R on M₂. Where were no differencein the activity of ACTH in group S and S-R. Compared to the activity ofACTH on M₂ and M₁ in group I, it was obviously increase on M₂. Comparedto the activity of ANP on M₁ and M₂, M₃, it was decreased on M₃ in groupI. In comparison to the group I, the activity of ANP was increasedobviously in group S and S-R on M₂. Compared to group I, the time of soberwas obviously decreased in group S and S-R.Conclusion In this study, we found that both simple inhalationanesthesia and intravenous add inhalation anesthesia of sevofluane canrestrain the harmful stress response during laparoscopic cholecystectomy,and the effect of simple inhalation anesthesia of sevofluane is worse thananother.