Comparing Effects Of General Anesthesia Combined Propofol, Etomidate, Sevoflurane With Remifentanil Target-controlled Infusion (TCI) On Hemodynamic Changes In Patients Undergoing Laparoscopic Cholecystectomy (LC)

Objective:To evaluate the hemodynamic effects of general anesthesia using propofol,vs etomidate, vs sevoflurane in combination with remifentanil target-controlled infusion(TCI) in patients undergoing laparoscopic cholecystectomy(LC).Methods:Sixty patients undergoing elective LC were randomly divided into propofol group(group P, n=20),etomidate group(group E,n=20) and sevoflurane group(group S,n=20).In group P anesthesia was maintained with TCI propofol(plasma target-controlled infusion concentrations 1.5～2μg/ml) and remifentanil(plasma target-controlled infusion concentrations 2～2.5ng/ ml);in group E TCI etomidate(plasma target-controlled infusion concentrations 0.3～0.32μg /ml) and remifentanil(plasma target-controlled infusion concentrations 2～2.5ng/ml) were given;in group S anesthesia was maintained with TCI remifentanil(plasma target-controlled infusion concentrations 2～2.5ng/ml) and continuous inhalation of sevoflurane(0.8～2.5 %,the end-tidal concentration was 0.4～1.2MAC).CO,CI,SV,SVI,SVR were recorded at before anesthesia induction,just after anesthesia induction,5 min after CO₂ pneumoperitoneum,20 min after pneumoperitoneum and 5 min after release of pneumoperitoneum.Results:There was no statistically significant difference in the hemodynamic parameters measured at the same time points among the three groups,but CO,CI,SV,SVI in group E were higher than in group P and group S,SVR in group E was lower than in group P and group S,even though the difference did not reach P＜0.05.Conclusion:Etomidate can be safely used in patients undergoing LC and easily gain more stable hemodynamics.