比较异丙酚和异氟醚对腹腔镜胆囊切除手术中血液动力学参数和应激反应激素的影响。

Sykepleien Pub Date : 2022-01-01 Epub Date: 2022-04-25 DOI:10.4103/joacp.JOACP_146_19
Ali Ghomeishi, Ahmad Reza Mohtadi, Kaveh Behaeen, Sholeh Nesioonpour, Elham Sheida Golbad, Nima Bakhtiari
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引用次数: 0

摘要

背景和目的:全身麻醉会诱发内分泌、免疫和代谢反应。麻醉药物通过改变患者的应激激素水平和血液动力学来影响内分泌系统。本研究的目的是比较异丙酚和异氟醚对腹腔镜胆囊切除术(LC)手术中血液动力学参数和应激激素的影响:本研究纳入了 70 名择期腹腔镜胆囊切除术(LC)患者。将患者随机分为两组,每组 35 人;P 组接受异丙酚(70-120 μg/kg/min)麻醉,I 组接受异氟醚(mac:1.28%)麻醉。按照计划方法,从麻醉前到进入 PACU 后 10 分钟,对以下参数进行了监测、检查和记录:血流动力学参数(心率和平均心房压)、血糖水平和血清肾上腺素水平:结果:两组心率和平均心房压的变化在所有阶段均无显著差异(P>0.05),但异氟醚组可耐受较低的波动变化。异氟醚组的血糖和血清肾上腺素水平升高明显高于异丙酚组(P < 0.05):结论:以异氟烷为基础的吸入气体维持麻醉与以丙泊酚为基础的全静脉麻醉在血流动力学参数上没有明显差异。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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of the effect of propofol and isoflurane on hemodynamic parameters and stress response hormones during Laparoscopic Cholecystectomy surgery.

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 P 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 (P > 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 (P < 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.

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