Effects Of Intravenous Glucose Infusion Before General Anesthesia On Stress Response During Laparoscopic Cholecystectomy

Objective:To study the effect of intravenous infusion of 5%glucose sodium chloride solution before general anesthesia on the stress response during laparoscopic cholecystectomy.Methods:Selecting 56 patients treated by laparoscopic cholecystectomy from July 2018 to December 2018,fasting 8 h,no drinking 6 h.The group was divided into two groups,saline group(N group)and glucose group(G group).Intravenous infusion of 5 ml/(kg.h)1 hour before anesthesia,0.9%sodium chloride solution in saline(N)and 5%glucose sodium chloride solution in glucose(G)(composed of 0.9%sodium chloride solution 0.25 g/kg glucose).Both groups of patients were treated with static aspiration combined with general anesthesia.Intravenous midazolam 0.04 mg/kg,propofol 2 mg/kg,sufentanil 0.4 ug/kg,induced by anesthesia.When the patient's consciousness disappeared and rocuronium was given 0.6 mg/kg,after complete relaxation of skeletal muscle,tracheal intubation was completed under visible laryngoscope,IPPV ventilation mode was performed,and respiratory parameters were set.Tidal volume(VT)6?8 ml/kg,respiratory frequency(RR)12?14beats/min,inspiration and expiration ratio(I:E)1:2,regulating oxygen flow 1?2L/min,oxygen concentration 100%.Sufentanil 0.2ug/kg,rocuronium 0.2mg/kg 3 min before operation.The anesthesia depth was maintained with sevoflurane during the operation,and the Bispectral index(BIS)was between 40?50.The monitoring time points were selected as follows:1 min(T1)before anesthesia induction,1 min(T2)after pneumoperitoneum and 1 min(T3)after cholecystectomy.Monitoring heart rate,Mean arterial pressure.Determination of whole blood glucose concentration,whole blood potassium ion concentration.The whole arterial blood was centrifuged with a centrifuge at 3000 rpm for 6 min,and plasma was collected and stored in a refrigerator at-80?.Plasma cortisol concentrations,adrenal hormone concentrations,and noradrenal hormone concentrations were determined using enzyme-linked immunosorbent agents.Using statistical software for analysis.Results:The general condition of the patients had no statistical difference(P>0.05).There was no significant difference in heart rate between the two groups(P>0.05),and the inner rate of the group was lower at the T2?T3 point than the T1 point(P>0.05).The mean arterial pressure in the two groups was at T2?T3 time,and the normal saline group(N group)was significantly higher than that in the glucose group(G group)(P<0.05);the mean arterial pressure in the glucose group(G group)was stable,and there was no significant change in the T1?T2?T3 time point;the normal saline group(N group)was significantly higher than T1 at the T2?T3 time point(p<0.05).whole blood glucose concentration,although glucose group(G group)was higher at all time points than normal saline group(N group),but decreased gradually at T2?T3 time points;the normal saline group(N group)T2?T3 the time point increased,and the T3 was significantly higher than the T1?T2 time point(P<0.05).Plasma epinephrine,norepinephrine,cortisol concentrations in the glucose group(G group)were lower at all time points than in the saline group(N group)(P<0.05).The plasma concentration of epinephrine in the glucose group(G group)did not change significantly at each time point;the epinephrine concentration in the saline group(N group)did not change significantly at the T1?T2 time point,and the T3 time point was significantly higher than time points(P<0.05).The plasma concentration of norepinephrine did not change significantly at not change significantly at the T1?T2 time point,and the T3 time point was significantly higher than the T1?T2 time point(P<0.05).The concentration of cortisol in the group was higher at the T1 time point than the T2 time point(P<0.05),and the T3 time point was significantly higher than the T2 time point(P<0.05).Conclusion:Intravenous infusion of 5%glucose sodium chloride solution 1 hour before general anesthesia can reduce intraoperative plasma epinephrine,norepinephrine and cortisol concentrations,stabilize whole blood glucose levels and reduce intraoperative stress response.