A comparative study of injecting air or carbon dioxide in patients undergoing routine painless colonoscopy after gynecological surgery

Objective To investigate the results of three formula of anesthesia management of propofol in the aged more than 80 years during colonoscopy. Methods 120 aged patients＞80 years scheduled to undergo painless colonoscopy were randomly divided into three groups,Group Ⅰ,Ⅱ and Ⅲ,each group 40 patients.Patients in Group Ⅰ received target controlled infusion of propofol and in Group Ⅱ received continuous infused propofol by vein pump,while patients in Group Ⅲ received manual controlled infusion of propofol.MAP、ECG、HR、SpO2 were recorded before colonoscopy,during and after colonoscopy.Anesthetic induction time,length of colonoscopy time,total propofol dosage,recovery time,side effects and satisfaction were also recorded. Results All patients had finished colonoscopy safely.There is no difference about MAP,ECG,HR and SpO2 among the three groups.The anesthetic induction time were (40±6),(58±10),(58±8) s,respectively.The recovery time were (3.7±1.3),(5.0±1.8),(6.9±1.7)min,respectively.The total propofol dosage were (91±11), (1 10±14), (131±16) mg,respectively.In Group Ⅰ,lower propofol dosage was recorded,anesthetic induction time and recovery time were shorter than those in Group Ⅱ and Ⅲ.The side effects were the least in Group Ⅰ and its satisfaction was the best. Conclusions It is satisfactory in aged patients＞80 years to administer propofol with different administration ways during colonoscopy.Target controlled infusion (TCL) of propofol may be the better way for the anesthesia ofthe aged during painless colonoscopy. Key words: The aged＞80 years; Painless colonoscopy; Propofol; Target controlled infusion

Objective To investigate the risk factors of respiratory depression and its sensitivity in predicting hypoxemia in painless colonoscopy. Methods A total of 120 patients [American Society of Anesthesiologists (ASA) grade Ⅰ-Ⅱ] who underwent painless colonoscopy from February to March 2018 were enrolled. The patients were divided into a respiratory depression group (group D) and a non-respiratory depression group (group N), according to whether respiratory depression [endtidal carbon dioxide partial pressure (PETCO2) ≥50 mmHg (1 mmHg=0.133 kPa) or disappearance of waveform ≥15 s] was achieved during surgery. The following indicators of both groups were recorded: gender, age, length of examination, propofol doses, body mass index (BMI), obstructive sleep apnea syndrome (OSAS) history, the interval from respiratory depression to hypoxemia [pulse oxygen saturation (SpO2) <90%] and the interval from the onset of hypoxemia alert values to hypoxemia. Results Remarkable difference was found in age, BMI, and OSAS history between the two groups, while age and BMI were the independent risk factors for respiratory depression. According to receiver operating characteristic (ROC) curve, age, BMI, and both can predict respiratory depression to some extent. Notably, the area under the ROC curve for both age and BMI was greater, compared with age and BMI alone (P<0.05). Compared with group N, group D had advantages in predicting hypoxemia(P<0.05). Compared with traditional oxygen saturation value (SpO2), monitoring PETCO2 predicted hypoxemia earlier, with earlier respiratory depression (63.9 s) than hypoxemia on average (SpO2<90%). Conclusions Patients with older ages and high BMI in painless colonoscopy are more likely to present respiratory depression. Monitoring PETCO2 can be more sensitive to predict the occurrence of hypoxemia, providing sufficient time for our treatment of hypoxemia to guarantee patient safety. Key words: End-tidal carbon dioxide partial pressure; Risk factors; Respiratory depression; Hypoxemia

Objective To explore the effect of different opioid analgesics on POFS after painless colonoscopy. Methods From October 2016 to February 2017, the 566 out-patients received by Northern Jiangsu People′s Hospital were divided into painless colonoscopy group and general colonoscopy group according to anesthesia or no.According to the random number table method, the painless colonoscopy group patients were randomly divided into remifentanil group, sufentanil group, fentanyl group and dezocine group.Routine colonoscopy operations were performed in painless colonoscopy group and general colonoscopy group.Patients in the remifentanil group received intravenous propofol and remifentanil, patients in the sufentanil group received propofol and sufentanil, patients in the fentanyl group received propofol and fentanyl, and patients in the decocinegroup received propofol and dezocine.Christensen fatigue score was used to evaluate POFS.Compared the POFS incidence, initial fatigue score and POFS duration between the groups. Results The incidence of POFS in the painless colonoscopy group (29.3%) was higher than that in the general colonoscopy group (6.4%), the initial fatigue score[(5.73±2.60)] was higher than that in the general colonoscopy group[(4.75±1.58)], and the POFS duration[(7.51±11.33) h] was lower than that in the general colonoscopy group[(31.31±32.00) h], with statistically significant differences (P<0.05). The POFS incidence (48.0%) of the dezocine group was significantly higher than that of the remifentanil group (20.7%), sufentanil group (23.4%) and fentanyl group (20.8%), with statistically significant differences (P<0.05). Initial fatigue score of the dezocine group[(6.62±2.68)] was significantly higher than that of the remifentanil group[(4.52±2.04)] and fentanyl group[(4.60±2.26)], with statistically significant differences (P<0.05). POFS duration between the sufentanil group and dezocine group[(11.69±18.69) h, (9.16±9.94) h] was significantly longer than that between the remifentanil group and fentanyl group[(2.50±3.68) h, (3.03±4.31) h], with statistically significant differences (P<0.05). Conclusion Different opioid analgesic had different effects on POFS.POFS in the dezocine group had the highest incidence of POFS, and POFS in the dezocine group and sufentanil group were heavier than those in the fentanyl group and remifentanil group.Fentanyl and remifentanil were ideal drugs in reducing POFS. Key words: Opioid analgesic; Painless colonoscopy; Postoperative fatigue syndrome; Anesthesia

Objective To explore the effectiveness of early bed gymnastics in the prevention of abdominal distension after gynecological surgery. Methods 100 patients undergoing gynecological abdominal surgery were randomly divided into study group and control group, 50 for each. The study group received education on early exercise with leaflets on bed gymnastics and started learning preoperatively and practised bed gymnastics postoperatively; while the control group received conventional care. Time to bowel sound recovery and to passing flatus and the rate of abdominal distention were observed. Results The time to bowel sound recovery and to passing flatus and the rate of abdominal distention differed significantly between the two groups (χ2= 34.29, P＜0.01; RSR = 6.19, P＜0.05; χ2= 4.433, P＜0.05). Conclusions Early bed gymnastics after gynecological surgery can shorten the recovery time of gastrointestinal function, and promote early flatus passing, and prevent postoperative abdominal distension. Key words: Abdominal surgery; Early exercise; Bed gymnastics; Abdominal distension

Objective To explore the anesthetic effect of low dose remifentanil in patients undergoing sequential painless gastroscopy and painless colonoscopy in accordance with intravenous induction of propofol. Methods From July 2017 to January 2018, 86 patients who needed painless gastroscopy and painless colonoscopy in sequence were selected as observation objects in the Second Hospital of Jiaxing and were divided into control group and observation group according to random number table method, with 43 cases in each group.The control group was anesthetized with propofol only, while the observation group was anesthetized with low dose remifentanil in accordance with propofol.The occurrence of adverse reactions and recovery were compared between the two groups. Results The incidence rate of adverse reactions of the control group was 20.93%(9/43), which of the observation group was 13.95%(6/43), there was no statistically significant difference between the two groups (χ2=0.272, P=394). The recovery time and the observation time after awakening in the observation group were (7.19±1.98)min and (6.94±2.04)min, respectively, which were significantly shorter than those in the control group [(10.33±2.42)min and (11.69±3.21)min], the differences were statistically significant (t=6.585, 8.190, P=0.000, 0.000). Conclusion Intravenous induction with low dose remifentanil combined with propofol in patients undergoing painless gastroscopy and painless colonoscopy in sequence has less adverse reactions, good anesthesia persistence and short recovery time, which is worthy of clinical popularization. Key words: Gastroscopy; Colonoscopy; Anesthesia and analgesia; Remifentanil; Propofol

Objective To analyze of the relationship between level of anxiety and depression before surgery and anus exhausting time for patients after gynecological abdominal surgery. Methods A descriptive study was conducted with a survey of 100 cases of patients with gynecological abdominal surgery where the level of anxiety and depression before surgery and post-anus exhausting time were analyzed to explore the correlation between them. Results In the 88 valid questionnaires, the incidences of stress and anxiety before surgery were respectively 38.64%(34/84) and 19.32%(17/88) and the average anus exhausting time after surgery was (44.55 ± 13.90)hours; the anus exhausting time of anxious patients was significantly longer than that of non-anxious patients [(48.35±12.84)hours vs.(42.50±14.13)hours, t=-2.12, P<0.05] and bivariate Logistic regression analysis suggested that preoperative level of anxiety had a significant effect on anus exhausting time after surgery. Conclusions Stress, anxiety and other negative emotions can affect anus exhausting time after surgery and level of anxiety could be used as one predictor of the delay of anus exhausting time after surgery. Key words: Anxiety; Gynecological surgery; Anus exhausting time; Stress

Objective To explore the application of intelligent operation arrangement software in shift scheduling in Gynecological Laparoscopic Operating Room. Methods From January 2013 to December 2017, 13 905 patients' profiles of gynecological laparoscopic surgery in the Gynecological Laparoscopic Operating Room of Zhejiang Provincial People's Hospital were collected. The daily operation volume, specific time of single operation, preparation time of different types of gynecological laparoscopic surgery, and special instruments transmission for gynecological laparoscopic surgery and time of patients' awakening from anesthesia and transfer were analyzed and counted. A database of specialist operations was established. Weights were determined according to key information and data, and relevant calculation formulas were formulated for data calculation. Artificial intelligence scheduling was carried out on the basis of original operation arrangement by simulation and comparison. Results The average annual, monthly, weekly and daily operation volume from 2013 to 2017 were 1 005.7, 85.6, 24.2 and 6.8, respectively. There were statistically significant differences in the average operation time of single gynecological laparoscopic surgery between different medical groups (P< 0.05) . The data of different types of gynecological laparoscopic surgery such as interval preparation time, material flow transmission of gynecological laparoscopic surgical instruments and transfer time of anesthesia recovery were input into computer to establish and improve the database of gynecological laparoscopic surgery. The measurement model of different types of operation interval distribution was designed and completed, which improved the accuracy of time estimation and reliability of simulated intellectualized surgical planning . After adopting the intelligent simulation operation arrangement scheme to improve the efficiency of operation room and give priority to the humanization of operation team and patients, the service time for daily use of operating room was saved about 90 minutes and 45 minutes respectively compared with the traditional editor's shift scheduling. Conclusions Intelligent operation arrangement software can improve the efficiency of operating room for gynecological laparoscopic surgeries and gradually meet the humanistic needs of both doctors and patients in the process of operation. Through the development of internal and external interfaces, the hospital's intelligent and information management can be further improved. Key words: Operating rooms; Gynaecological surgery; Laparoscopic surgery; Nursing shift scheduling; Software; Intelligence; Informationize

Objective To investigate the efficacy and safety of different doses of dexmedetomidine (DEX) administered in the laparoscopic gynecological surgery. Methods Eighty patients ASA grades Ⅰ or Ⅱ,scheduled for elective laparoscopic gynecological surgery under general anesthesia were randomly divided into four groups,20 patients in each group:group A (Control group,10 ml normal saline),group B(0.25 μg/kg DEX),group C(0.5 μg/kg DEX),group D( 1.0 μg/kg DEX).Before induction of anesthesia,patients were administered intravenously 10 ml saline or different doses of DEX (diluted with saline to 10 ml) in 10 min with syringe pump respectively.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) and bispectral index (BIS) value were recorded 15 min after entering operating room(T0),after given dexmedetomidine infusion(T1),immediately before and after tracheal intubation(T2-T3),after pneumoperitoneu(T4),after skin incision(T5),at the end of surgery(T6) and extubation (T7),meanwhile the amount of propofol and remifentanil,recovery time,extubation time and adverse reactions were also recorded.Results In group A,B,SBP,DBP and HR at each time after intubation was significantly higher than that before induction,while in group C,D there were no significant changes in those parameters among the different time points.SBP, DBP and HR after intubation in group C and group D were lower than that at the same time point in group A and group B.At time point T1,HR were significantly decreased and SBP,DBP increased compared with that at time point T0- Values of BIS were significantly lower at time point T1 in group B,C and D (P＜0.05) compared with that at time point T0.Values of BIS at time point T1 in group B,C were significantly higher (P＜0.05) compared with that in group D.There were significant differences in the doses of propofol administered in four groups(P＜0.05),the doses were(834±109),(725±94),(615±110),(563±97) mg in group A,group B,group C and group D respectively.The doses of remifentanil used in four groups were respectively(562±53),(497±32),(431±41),(442±37) μg.Recovery time and extubation time of the patients among 4 group were no statistically significant different (P＞0.05).The dosage of epherine and atropine administered in group D increased obviously (P＞0.05) and higher incidence of chill,dysphoria and cough was observed in group A and group B (P＞0.05). Conclusions Before induction of anesthesia,administration of different doses of DEX have significant sedative effects on patients,can reduce the dose of propofol and remifentanil and may reduce the adverse reactions.Cardiovascular parameter changes was more stable within different stage of surgery in the group which 0.5 μg/kg DEX was administered before anesthesia. Key words: Dexmedetomidine; Laparoscopic gynecological surgery; Hemodynamics; Sedation; Adverse reactions

Objective To investigate the clinical application of acupuncture combined with general anesthe -sia in gynecologic laparoscopic surgery .Methods 60 ASA（ the American society of anesthesiologists ）Ⅰ-Ⅱpatients undergoing elective gynecologic laparoscopic surgery were randomly divided into the acupuncture group and control group.Patients in the acupuncture group were chosen Hegu （LI 4）,Neiguan（PC 6） on both sides.After acupuncture, the two acupoints,electroacupuncture stimulated 20-30min,then administered general anesthesia ,electroacupuncture until surgery finished ,the control group received general anesthesia only .The drug dosages of the two groups was regu-lated,maintained anesthesia depth bispectral index （ BIS） between 40 and 60.The changes of the blood pressure （ BP） ,heart rate and BIS of the two groups at the same time points were observed;the propofol and remifentanil dos-age after the surgery ,the awaken time and extubation time ,OAA/S score and pain score after wake ,the happening of restlessness,chills,nausea and vomiting ,the usage of narcotic analgesics postoperation ,and the intraoperative aware-ness were recorded .The effect of acupuncture combined with general anesthesia was evaluated .Results Anesthetic dosage propofol of the acupuncture group [（7.44 ±1.30）μg· kg-1· h-1] was less than [（8.66 ±1.24）μg· kg-1· h-1] of the control group （t=3.720,P=0.001）,remifentanil dosage was also less than the control group [acupunc-ture group （10.59 ±2.58）μg· kg-1· h-1,control group （11.93 ±2.27）μg· kg-1· h-1,t=2.168,P=0.034]. Compared with the basic value ,the BP values were higher at the time of intraoperation ,waking,extubation and 10 min after extubation （all P〈0.05）,the acupuncture group had more stable BP .Compared with the acupuncture group , heart rates in the control group were faster at extubation and 10min after extubation .Recovery time and extubation time of the acupuncture group were （9.05 ±2.36）min and （1.61 ±2.40）min,which were shorter than （12.50 ± 3.20）min and （15.90 ±3.37）min of the control group （P〈0.05）.Pain score（VAS） in the acupuncture group was lower than that of the control group .Consciousness score was higher in the acupuncture group ,the incidence rates of restlessness,chills were less.Conclusion The use of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery can reduce the dosage of general anesthetics ,shorten the awaken time and extubation time ,increase the OAA/S score of the patients ,relieve pain ,and the recovery quality is higher . Key words: Anesthesia, general ; Laparoscopy ; Acupuncture ; Combined anesthesia; Gynecology ; Surgery

Since a standard sedation protocol for pediatric colonoscopy (CS) has not been established, evidence on optimal sedative agents is needed. This study aimed to evaluate the efficacy and safety of thiamylal in sedation for pediatric CS compared to midazolam. Children from 7 to 16 years of age who underwent CS under sedation with intravenous thiamylal or midazolam at our hospital between June 2010 and March 2024 were included in this retrospective observational study. The primary outcome was the efficacy (success rate of CS without mid-awakening) of the drugs. Meanwhile, the secondary outcomes were the sedation level during CS, procedure time, recovery time, and adverse events related to sedation. Sixty children were included in the study. The success rate of CS without mid-awakening was significantly higher in the thiamylal group (90.6%) than in the midazolam group (64.3%; p = 0.03). The two groups had no significant differences in median sedation depth, procedure time, or recovery time. Adverse events related to sedation in thiamylal group (22%) and midazolam group (25%) were similar. No severe adverse events were reported. Intravenous thiamylal provides effective and safe sedation in children requiring CS, with little or no mid-awakening during the procedure.

Due to the advantages of laparoscopic surgery, such as less bleeding, small trauma, rapid recovery, shorter hospitalization duration and so on, it has been widely used in clinical. At present, more and more gynecological surgeries can be completed by laparoscopic surgery. With the popularization and application in gynecological surgery, the grasp of laparoscopic surgery operation indications and expanding of operation scope, complication rate in gynecological laparoscopic operation decreased obviously. However, the complications of absolute number and kinds of complications increased obviously. Gynecological laparoscopic surgery complications include: urinary system injury, bowel injury, stomach injury, bleeding, subcutaneous emphysema, lower limb venous thrombosis, pelvic infection, poor healing of incision, poor union of vaginal stump, tissue ectopic implantation, etc.. In this paper, the authors would review the injuries, clinical characteristics and prevention and treatment measures of these complications, to provide references for clinical prevention and treatment of gynecological laparoscopic surgery complications. Key words: Laparoscopes; Gynecologic surgical procedures; Wound and injuries; Complications; Preventive measures; Female

Objective To evaluate the effects of different doses of dexmedetomidine on propofol-induced inhibition of responses to laryngeal mask airway （LMA） insertion when combined with fentanyl in patients undergo- ing gynecological operation. Methods One hundred and twenty-five ASA Ⅰ-Ⅱ female patients, aged 20-60 yr, scheduled for elective short-time surgery, were randomly divided into 5 groups （ n = 25 each） ： normal saline group （group NS） and different doses of dexmedetomidne groups （groups D1-4 ）. Normal saline 40 ml and dexmedeto- midne 0.4, 0.6, 0.8, 1.0 μg/kg （in 40 ml of normal saline） were infused over 10 min in groups NS and D1-4 re- spectively. 1% propofol was then given by target-controlled infusion. The concentration of propofol was determined by using modified Dixon＇s up-and-down method. The initial plasma concentration of propofol was 3.0 μg/ml and the ratio between the 2 successive concentrations was 1.1. Fentanyl 1. 5μg/kg was injected intravenously when the effect-site concentration of propofol reached the preset plasma concentration. LMA was inserted 4 min later. When LMA insertion was successful, the concentration of propofol was decreased in the next patient and when LMA inser- tion failed, the concentration of propofol was increased in the next patient. Failure of LMA insertion was defined asdifficulty in inserting LMA or body movement, corner of mouth movement, biting LMA, swallowing and/or lacrima- tion during insertion. The median effective target effect-site concentration and 95 % confidence interval of propofol blunting responses to LMA insertion when combined with fentanyl were calculated. Results The median effective target effect-site concentration （95% confidence interval） of propofol blunting responses to LMA insertion when combined with fentanyl were 3.09 （2.83-3.36）, 2.48 （2.26-2.73）, 2.29 （2.18-2.41）, 2.04 （1.95-2.12） and 1.67 （1.55-1.81 ）μg/ml in groups NS and D].4 , respectively. Conclusion Dexmedetomidine can enhance propo- fol-induced inhibition of responses to LMA insertion when combined with fentanyl in dose-dependent manner in pa- tients undergoing gynecological operation. Key words: Dexmedetomidine ; Propofol ; Piperidines ; Dose-response relationship, drug ; Laryngeal masks; Gynecologic surgical procedures

Objective To evaluate the influence of the duration of patient-controlled intravenous analgesia (PCIA)on pain and gastrointestinal function after gynecological abdominal surgery.Methods Patients who received gynecological abdominal surgery were divided into 3 groups according to using time of PCIA for 24 hours,48 hours,72 hours.There were 30 cases in each group.Pain intensity,gastrointestinal peristalsis time,anal exhaust time,getting out-of-bed time,voluntary micturition time,nausea and vomiting were compared among three groups after stopping PCIA.Results There were no significant differences in VAS score among three groups at each time point.There were no significant differences in voluntary micturition time among three groups.The anal exhaust time,getting out-of-bed time in 24-hour group were earlier than those of the other two groups,the differences were significant; The nausea and vomiting in 24-hour group were lower than the other two groups,the difference was significant.Conclusions The application of PCIA can effectively relieve acute pain 24 hours after surgery,but the effect was not obvious on pain induced by activities after 24 hours.But the side effects induced by analgesia pump(anesthetic)still work,such as vomiting,long duration of discharge,activity inconvenience.So PCIA should be stopped at right time in order to reduce complications and facilitate for recovery of patients after the surgery. Key words: Gynecological abdominal surgery; Pain control; Duration; Adverse reaction

Objectives To investigate the effect of carbon dioxide pneumoperitoneum on postoperative cognitive dysfunction and the level of serum NSE and S-100β protein in female patients undergoing gynecological laparoscopy. Methods 60 ASA physical status Ⅰ patients were divided two groups, group Ⅰ received no insufflation andconventional abdominal surgery ( n = 30) and group Ⅱ received abdominal insufflation and gynecological laparoscopy ( n =30). MMSE was recorded at several different time points, including one day before operation, 1, 6, 24, 48, 72h after operation, and before discharge. Serum S-100β protein and NSE was measured by ELISA before the beginning of operation ( or carbon dioxide pneumoperitoneum) and 1h after operation (or carbon dioxide pneumoperitoneum). Results MMSE values at 1,6,24,48,72h decreased significantly in group Ⅱ (24. 67 ± 1.47,25.97 ± 1.50,26. 77 ± 1.61,27.07 ± 1.87,27.37 ± 2. 06) after operation, compared with group Ⅰ (27.63 ± 1. 33,27.27 ± 0. 87,28.37 ± 0. 85,28.73 ±0. 78,29. 23 ±0. 86, P 0. 05].Serum of S-100β protein and MMSE were significantly correlated w group Ⅰ and Ⅱ ( r = 0. 6412,0. 8126, P 0.05),whereas NSE and MMSE had significant correlation in group Ⅱ ( r = 0. 7111, P <0. 01 ). Conclusions Carbon dioxide pneumoperitoneum in patients with gynecological surgery might affect postoperative cognitive function, and MMSE score was negatively correlated with serum S-100β and NSE proteins. Key words: Pneumoperitoneum,artificiaL/AE; Carbon dioxide; Laparoscopy; Cognition; S100 proteins/ME; Phosphopyruvate hydratase/ME

Objective To observe the effect and dose of sevoflurane combined with propofol anesthesia for laparoscopic cholecystectomy. Methods A total of 120 patients undergoing laparoscopic cholecystectomy were prospectively studied. According to the random number table, the patients were divided into group A, group B, group C, and group D, with 30 cases in each group. Anesthesia program: group A of 1% propofol, group B of 2% propofol, group C of 1% propofol + sevoflurane, group D of 2% propofol + sevoflurane. The time of consciousness disappearance, the time of Narcotrend index down to 36, the dosage of propofol within 60 min, and the total dosage of propofol, heart rate (HR) and mean arterial pressure (MAP) at T0 (entering the room), T1 (intubating), T2 (incising), T3 (abdomen closing), T4 (extubation), the recovery time of spontaneous breathing, eye opening time, extubation time were compared among the four groups. Results There were statistically significant differences in the time of consciousness disappearance, the time of Narcotrend index down to 36, the dosage of propofol within 60 min, and the total dosage of propofol among the 4 groups (P 0.05). The dosage of propofol within 60 min and the total dosage of propofol were the highest in group B, the lowest in group C, there were no statistically significant differences between group A and D (P>0.05). There were no statistically significant differences in HR and MAP among the four groups at each time point (P>0.05); there were no statistically significant differences in HR at different time points in each group (P>0.05); MAP in the 4 groups at T1 were significantly lower than those at T0, and MAP in the 4 groups at T2 were significantly higher than those at T0 (P<0.05). The recovery time of spontaneous breathing, eye opening time, extubation time of group C and D were all shorter than those of group A and B (P<0.05). Conclusions Compared with propofol total intravenous anesthesia, sevoflurane combined with propofol anesthesia for laparoscopic cholecystectomy can get better wake quality, and 1% of propofol has better pharmacodynamics, which can reduce the dose of propofol. Sevoflurane combined with 1% propofol is a kind of ideal anesthesia program for laparoscopic cholecystectomy. Key words: Laparoscopic cholecystectomy; Sevoflurane; Propofol; Dose