| Objective To observe changes and clinical significance of heart rate variability (HRV) in cholecystectomy.Methods Senventy patients, ASA gradeⅠ-Ⅱ, aged 25 to 65 years, undergoing elective cholecystectomy, were included in this study. They were undergoing intravenous anaesthesia with trachea intubatton. Low frequency(LF), high frequency (HF), LF/HF, LFnu (LF/TP×100%), HFnu (HF/TP×100%) and total power (TP), were monitored 5 minutes before dragging cholecyst, at the moment of dragging cholecyst and 5,10 minutes after dragging cholecyst during cholecystectomy.Resluts Compare with those before dragging cholecyst, TP was increased significantly (P<0.05) at the moment of dragging cholecyst. At 5 minutes after dragging cholecys, HFnu was decreased significantly (P<0.01) and LF/HF was decreased significantly (P<0.05). At 10 minutes after dragging cholecys, TP was decreased significantly (P<0.05).Conclusion The autonomic balance at 5 minutes after dragging cholecyst had an increasing parasympathetic activity. Objective To observe changes and clinical significance of Pulse transit time (PTT) in cholecystectomy.Methods Forty three patients, ASA gradeⅠ-Ⅱ, aged 25 to 65 years, undergoing elective cholecystectomy, were included in this study. They were undergoing intravenous anaesthesia with trachea intubation. ECG,BP,HR were mornitoring at time of induction of anesthesia (T1), tracheal intubation (T2) and skin incision (T3) during cholecystectomy. At the same time we measured changes in RR interval (RR-int) and rPTT. rPTT was estimated as the interval from the peak in the R-wave to detection of the pulse oximeter waveform in the periphery.Resluts Compare with baseline at time of induction of anesthesia HR,MAP were decreased significantly (P<0.05), rPTT was increased significantly (P<0.05). At time of tracheal intubation HR,MAP were decreased significantly (P<0.05), rPTT was increased significantly (P<0.05). At time of skin incision HR,MAP were decreased significantly (P<0.05), rPTT was increased significantly (P<0.05).Conclusion Variation in rPTT reflects autonomic responses to nociceptive stimulation and fluctuations in anaesthetic depth independently of heart rate during cholecystectomy. cholecystectomy.Methods By simple randomization 70 patients undergoing laparoscopic cholecystectomy were assigned to two groups, 68 patients completed the study (35 in each group), ASA gradeⅠ-Ⅱ.Group GA patients under general anesthesia. Group GALA, patients under general anesthesia combined with local anesthetic. Heart rate variability monitoring,Low-frequency(LF), high-frequency (HF), LF/HF, LFnu (LF/TP×100%), HFnu (HF/TP×100%) and total-power (TP), were recorded at the time points of baseline(T0), skin incision(T1), skin closure(T2) and 1h(T3),3h(T4) after surgery. Hemodynamic monitoring,MAP and HR were recorded at the points of baseline, skin incision, skin closure and 1,3 h after surgery.Results Compared with the baseline, there was a increase in MAP and HR at T1,T3,T4 (P<0.05)in group GA. Heart rate variability changes showed that in group GA LFnu, LF/HF increased significantly at T1,T2,T3,T4 (P<0.05) and in group GALA LF/HF increased significantly at T1,T2 (P<0.05), and TP in group GA and group GALA decreased significantly at T1,T2 (P<0.05).Conclusion Our results support that combined general anesthesia with local anesthetic infiltration has less influence on hemodynamics and automomic nerve, and can be a useful analgesic adjunct for patients who are undergone laparoscopic cholecystectomy. Objective To appraise the effect of prophylactic fructose-1,6-diphosphate (FDP) combined with local block at the neck of gallbladder on heart rate variability (HRV) and hemodynamics in cholecystectomy.Methods Forty four patients, ASA gradeⅠ-Ⅱ, aged 25 - 65 years, undergoing elective cholecystectomy, were divided two groups in this study. They were undergoing intravenous anaesthesia with trachea intubatton. In test group, in addition to local block , the patients received FDP (200mg.kg-1) intravenously before skin incision. MAP, HR, Low frequency (LF), high frequency (HF), LF/HF, LFnu (LF/TP×100%), HFnu (HF/TP×100%) and total power (TP), were monitored 5 minutes before dragging cholecyst, at the moment of dragging cholecyst and 5,10 minutes after dragging cholecyst during cholecystectomy.Results At the moment of dragging cholecyst, TP was decreased significantly (P<0.05) in both groups. At 5 minutes after dragging cholecys, MAP,HR , HFnu and LF/HF were decreased significantly (P<0.01) in control group, and HR was decreased significantly (P<0.05) in test group. At 10 minutes after dragging cholecyst, TP was decreased significantly (P<0.05) in both groups, and MAP, HR decreased significantly (P<0.05)compared with the moment of dragging cholecyst.Conclusion Our results support that prophylactic fructose-1,6-diphosphate (FDP) combined with local block at the neck of gallbladder has less influence on hemodynamics and HRV, and can be effective in dealing with cholecystocardiac reflex. |
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