Effects Of Sevoflurane And Propofol Anesthesia On Intraoperative Endothelial Cell Function In Patients Undergoing Laparoscopic Cholecystectomy

[Objective] To investigate the effects of sevoflurane and propofol anesthesia on intraoperative active or damaged signs of endothelial cell, such as P-selectin, intercellular adhesion molecule-1 (ICAM-1) and thrombomodulin (TM) for chosing an optimal anesthetics which suppress the traumatic inflammatory response to provide the theoretical warranty in clinical.[Methods] From March 1 2010 to March 31 2010, we conducted a group sequential trial on the patients which met the study standard and received a laparoscopic cholecystectomy in Zhongshan Hospital affi-liated Fudan University. According to the different anesthesia protocol, patients were stratified into the groups of sevoflurane (Group S) or propofol (Group P). All the blood samples in each patient were taken from peripheral vein at before induction (T0), after induction but before pneumoperitoneum (T1),15mins after pneumoperitoneum (T2), immediately after extubation (T3) and 30mins after extubation (T4). Two groups of patients were analyzed with general demographic information, clinical information and the expression of P-selectin, ICAM-1 and TM. SPSS16.0 software packages carried out the use of statist ics and the threshold of statistical significance was P<0.05.[Results] A total of 23 patients were enrolled in this study,11 of them belonged to Group S, the others belonged to Group P. There was no significant difference between two groups in general demographic infor-mation and clinical information. Compared with T0, the expression of P-selectin and TM in Group S had a significant increase (P<0.05), while ICAM-1 had a steady level (P>0.05). In Group P, the trend of P-selectin, ICAM-1 and TM was the same with Group S. Except P-selectin had a still high level (P<0.05), the expression of ICAM-1 and TM at all time show-ed no significant difference (P>0.05). Comparing Group S with Group P at any time, we found the level of P-selectin and TM at T1, T2 or T3 in Group P was significant lower than that in Group S (P<0.05); the expression of TM had a significant decrease at T2 and T3 (P<0.05).[Conclusion] Sevoflurane and propofol were not completely inhibit the activation and damage of endothelial cell in laparoscopic cholecystec-tomy. To the patient undergoing laparoscopic cholecystectomy, using propofol can provide more effective protection to the function of endothelial cells during the operation.