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丙泊酚与异氟烷对腹腔镜胆囊切除术期间血流动力学参数及应激反应激素影响的比较

Comparison of the effect of propofol and isoflurane on hemodynamic parameters and stress response hormones during Laparoscopic Cholecystectomy surgery.

作者信息

Ghomeishi Ali, Mohtadi Ahmad Reza, Behaeen Kaveh, Nesioonpour Sholeh, Sheida Golbad Elham, Bakhtiari Nima

机构信息

Pain Research Center, Imam Khomeini Hospital Research and Development Unit, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.

Department of Anesthesiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.

出版信息

J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):137-142. doi: 10.4103/joacp.JOACP_146_19. Epub 2022 Apr 25.

Abstract

BACKGROUND AND AIMS

General anesthesia induces endocrine, immunologic, and metabolic responses. Anesthetic drugs affect endocrine system by changing the level of stress hormones and hemodynamic of the patient . The purpose of this study was to compare the effects of propofol and isoflurane on hemodynamic parameters and stress-induced hormones in laparoscopic cholecystectomy (LC) surgery.

MATERIAL AND METHODS

Seventy patients of elective LC were included in this study. Patients were randomly divided into two equal groups of 35 patients; group received propofol (70-120 μg/kg/min) and group I received isoflurane (mac: 1.28%) as anesthesia maintenance. The following parameters were monitored, checked, and recorded from preanesthesia period to 10 min after PACU entry according to a planned method: hemodynamic parameters (heart rate and mean atrial pressure), level of blood sugar, and serum epinephrine level.

RESULTS

Heart rate and mean atrial pressure changes did not show significant differences between the two groups in all stage ( > 0.05), but isoflurane group tolerated lower fluctuating changes. Blood glucose and serum epinephrine level rise in the isoflurane group were significantly higher than the propofol group ( < 0.05).

CONCLUSION

Maintenance anesthesia by inhalation gas base on isoflurane has not shown a significant difference with total intravenous anesthesia base on propofol on hemodynamic parameter. However, propofol has a consistent effect on decreasing stress hormone and suggested for LC surgery.

摘要

背景与目的

全身麻醉会引发内分泌、免疫和代谢反应。麻醉药物通过改变患者应激激素水平和血流动力学来影响内分泌系统。本研究旨在比较丙泊酚和异氟烷对腹腔镜胆囊切除术(LC)患者血流动力学参数及应激诱导激素的影响。

材料与方法

本研究纳入70例行择期LC的患者。患者被随机分为两组,每组35例;P组给予丙泊酚(70 - 120μg/kg/min),I组给予异氟烷(最低肺泡有效浓度:1.28%)作为麻醉维持。按照预定方法,监测、检查并记录从麻醉前至进入麻醉后恢复室(PACU)10分钟后的以下参数:血流动力学参数(心率和平均心房压)、血糖水平及血清肾上腺素水平。

结果

两组在各阶段的心率和平均心房压变化均无显著差异(P > 0.05),但异氟烷组的波动变化较小。异氟烷组的血糖和血清肾上腺素水平升高显著高于丙泊酚组(P < 0.05)。

结论

基于异氟烷的吸入性气体维持麻醉与基于丙泊酚的全静脉麻醉在血流动力学参数方面未显示出显著差异。然而,丙泊酚在降低应激激素方面具有一致的效果,建议用于LC手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e22/9191818/ed5c2b81841b/JOACP-38-137-g001.jpg

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