Effects Of Desflurane On Anesthesia Recovery In Elderly Patients With Laparoscopic Colorectal Cancer Surgery

Objectives:Through the observation of laparoscopic colorectal surgery in elderly patients,use desflurane or sevoflurane for anesthesia maintenance.Compare the different of desflurane and sevoflurane for elderly patients with laparoscopic colorectal cancer surgery on postoperative recovery.Methods:In our study,we chose the age of 65-80 years old elderly patients with ASA physical status Ⅱ to Ⅲ,undergoing laparoscopic colorectal surgery from The Second Hospital of Jilin University in August 2016 to February 2017.A total of 74 patients were randomly divided into two groups: experiment group Desflurane（group D,38 cases）and control group Sevoflurane（group S,36 cases）.Both groups were treated under vein induced anesthesia.The both groups patients received Midazolam 0.05mg/kg,fentanyl 4μg/kg,cisatracurium 0.15mg/kg,Etomidate 0.03mg/kg for anesthesia induction.In the group D,the desflurane volume fraction was slowly increased from the end of induction,maintained at 6-8% desflurane inhalation during the operation.In the group S,the patients was inhaled 1.5-3% sevoflurane.Both groups were kept inhaled anesthesia at 1.3 MAC.The volume fraction of the inhaled anesthetic was adjusted according to the surgical stimulus and the BIS value,so that the BIS value was maintained 45-60 in the surgery.And continued injection of remifentanil 5ug/（kg·h）.We intermittently（interval of 30 minutes）injected of cisatraeurium 5mg,and stop adding at the half an hour before the end of the surgery.The fentanyl 0.1mg was given at the time of cut the skin and the 5minutes before the end of the operation.The mean arterial pressure MAP（mm Hg）,heart rate HR（bpm）and carbon dioxide partial pressure PETCO2（mm Hg）were recorded at every time points（before anesthesia induction T₀,intubation time T₁,10 minutes after anesthesia T₂,30 minutes after operation T₃,end of surgery T₄,and extubation time T₅,10 minutes after extubation T₆,20 minutes after extubation T₇）.Record the time of operation,the time to wake up,the time of extubation,the time in the PACU,the time from the care ward to the general ward（the time in the care ward）.The adverse events,emergence agitation,lethargy（such as sleepiness,coping with unresponsive）,nausea and vomiting,skin itching,and respiratory depression（Sp O2≤90%）were recorded in the PACU.Results:1.There was no significant difference in general information.2.There was no significant difference in mean arterial pressure and heart rate between the two groups.3.The time of awakening,extubation,in the PACU and in the care ward,group D were shorter than those of group S（p<0.05）.4.The postoperative emergence agitation score in the group D was lower than that of in the group S（p<0.05）.5.In PACU,the number of cases of drowsiness and respiratory depression,in the group D,was lower than the group S（p<0.05）.And there was no significant difference in the number of cases of nausea,vomiting and skin itching.Conclusions:In elderly patients undergoing laparoscopic colorectal surgery,the use of desflurane for anesthesia maintenance can make it extubation and recovery time shortened and improve the quality and safety of the recovery period.The impact of anesthesia recovery period is small.Can effectively accelerate the PACU and the operating room turnover and also can improve the work efficiency and reduce waste of resources.In PACU,the scores of agility and adverse events were significantly lower in the desflurane group than in the sevoflurane group,which is conducive to postoperative recovery in elderly patients.Thus,desflurane can be used as elderly patients with laparoscopic colorectal cancer surgery anesthesia program,which is conducive to the recovery of elderly patients with rapid recovery.So that the concept of ERAS in colorectal surgery to be reflected.