The Influence Of Progesterone Levels Of Middle-aged People On Propofol Sedative Effect

Objective: To observe how the progesterone affect thepropofol sedative-effect, and to explore the mechanism ofthe gender diffference in the sedative-effect of propofol.Material and methods:60non-premedicated patients,aged45~55years, ASA I or II,who received laparoscopiccholecystectomy were included. All cases were randomlydivided into four groups: male group(group A),menopausal women group(group B),The other two groupswere divided according to different menstrual cycle:follicular group(group C) and luteal group(group D),Therewere15patients in each group. Anesthetic method: All thepatients were monitored ABP,HR,ECG,SPo2andBIS.Anesthesia was in duced with propofol at the rate of200ml/h via TCI pump firstly,When the patients were induced with propofol at about0.8mg/kg, The infusing ratewas changed to50ml/h. The responsiveness portion of theThe observer’s assessment of the alertness/sedationscale(OAA/S) were as the criterin to determine the level ofsedation. loss of consciousness was defined as OAA/S≤2(loss of responsiveness to light tapping on left shoulder ormild shaking with voice command to open eyes). When thepatient losed consciousness, record the value of BIS and theamount of propofol.At the same time, sulfentanyl0.3～0.5μg/kg， and cisatracurium0.2mg/kg were given, Propofoland remifentanyl were administered via continuous infusingpump. We monitor MAP，HR，SpO2，BIS at five time points:intering time (T1), intubation time(T2),operation start time(T3), finshing time(T4), Laryngeal mask pulling up time(T5).Record the amont of induced propofol, operatory time,recovery time, the amont of propofol confused.Result:1、The comparison of propofol induction dosagein last three groups: luteal group(group D) was much lessthan follicular group(group C) and menopausal group(group A), The difference were statistically influent（P<0.05）.There were no significant differences betweenthe follicular group(group C) and menopausal group (group A)（P＞0.05）.2、When compared with the amount of ofpropofol maintain,there were no significant differencesbetween the four groups（P＞0.05）. In the comparison of theAmount of Refentanil maintain, there were no significantdifferences between the four groups（P＞0.05）.3、Whencompared with the Wake up of time, menopausal group(group A) consumed longer time to open eyes than lutealgroup(group D), The difference was statistically significant（P<0.05）.there were no significant differences between theother groups(P>0.05).4、In the four groups, the value of BISat wakeup had no significant difference (P>0.05). similarly,The value of BIS for loss of consiciousness between thefour groups had no significant difference (P>0.05)Conclusion:(1) Female hormones Reaction during theDifferent menstrual cycle do not affect the value BIS whichreflect the depth of anesthesia.(2) The dosage of propofolfor general anesthesia induction was less in luteal group thanthe other groups, which pointing out high-levelsprogesterone was one of the reasons.(3) Recovery time maybe affected by the levels of Progesterone.