Effect of Target-controlled Infusion Anesthesia on the Stress Response in Patients Receiving Laparoscopic Cholecystectomy / 中国微创外科杂志

ABSTRACT

Objective To compare the effects of target-controlled infusion (TCI) of propofol and remifentanil and inhalation anesthesia on the stress response in patients undergoing laparoscopic cholecystectomy (LC). Methods Selective LC was performed on 60 cases. Before the surgery,the patients were randomly divided into experiment (TCI of propofol and remifentanil) and control (standard general anesthesia combined with inhalation of fluorinated alkane and laughing gas) groups with 30 cases in each. The serum levels of cortisol and IL-6 were detected before the induction (t1) and 20 minutes after pneumoperitoneum (t2). In addition,the MAP and HR of the two groups were monitored at seven time points. Results The serum levels of cortisol and IL-6 in the experiment group were similar to those in the control at t1 [Cortisol(227.48?50.81) ?g/L vs (233.21?41.02) ?g/L,t=0.481,P=0.633; IL-6(105.99?30.65) ng/L vs (111.20?34.80) ng/L,t=-0.615,P=0.541],but significantly lower at t2 [Cortisol(241.00?69.11) ?g/L vs (354.70?37.55) ?g/L,t=7.918,P=0.000; IL-6(116.06?30.89) ng/L vs (172.73?23.54) ng/L,t=-7.992,P=0.000]. The MAP and HR in the experiment group were significantly lower than those in the control at t2 to t5 (5,10,15,and 20 minutes after the pneumoperitoneum; P