The Effects Of Lidocaine On Target-controlled Infusion Of Propofol And Stress Reaction For Laparoscopic Cholecystectomy

Object To evaluate the effects of lidocaine on target-controlled infusion of propofol and stress reaction. Methods Thirty ASA Ⅰ -Ⅱ patients aged between 22-65 yr and weighing 48-81 kg undergoing Laparoscopic cholecystectomy , were randomly allocated to one of three groups with 10 patients in each group: In propofol group(group P) anaesthesia was induced and maintained with propofol given by TCI; In lidocainegroup Ⅰ (group L1) and lidocaine group Ⅱ (group L2) anaesthesia was induced and maintained with propofol given by TCI and continuous lidocaine infusion, loading dose 1 mg·kg-1 , 2 mg ·kg-1 and 1 mg · kg-1 · h-1, 2mg · kg-1· h-1 for maintenance inspect. Anaesthesia was induced with fentanyl 3ug · kg-1 ,Diprifusor/TCI system in 2ug · ml-1 and vecuronium0.12mg · kg-1 , BIS was maintained at 50 ±5 by adjustment of target-effect propofol concentration. ECG, HR, MAP, SPO2, PetCO2, BIS, EMG and target-effect propofol concentration were continuously monitored. Plasma hydrocortisone, pancreatic glucagons and angiotensin Ⅱ concentration were determine before induction(T0), after intubation(T1), before operation (T2), before pneumoperitoneumwas ended(T3)and after extraduction(T4) . Result (1) target-effect propofol concentration: group P was significantly higher at every time than group L1 and L2 (p<0.05), group L2 was significantly lower at the time of awake and extraduction (p<0.05). (2) Plasma hydrocortisone concentration: T1, T3, T4 was higher than T0 in group P(p<0.05), group L2 was lower than group P at T1, T3, T4; Plasma pancreatic glucagons concentration: compared with To, group P was significant higher at every time, group L1 and L2 was significant lower at T3,T4 than group P; Plasma angiotensin Ⅱ concentration was higher at T1,T2,T3,T4 than at T0 but no difference in three groups.(3) Fluctuation of blood pressure: blood pressure was significant higher at Tl in group P than at T0, but no difference in group L1 and L2; then blood pressure was significant higher in operation period and no difference in three groups.Heart rate was no difference in three groups in anaesthesia period.(4) Recovery time was significant longer in group L1 and L2, group L2 was significant longer than group L1. Conclusion Infusion lidocaine can decrease the target-effect propofol concentration and the stress reaction in operation, but can make the recovery time longer.