Effect of combined application of sevoflurane and remifentanil on laparoscopic surgery, postoperative recovery time and stress response

Abstract

Purpose: To investigate the effect of application of sevoflurane and remifentanil on laparoscopic surgery, and its effect on patients’ postoperative recovery time and stress response. 
 Methods: Ninety patients undergoing laparoscopic surgery in Zhongshan City People's Hospital, Guangdong Province, China were selected and randomly divided into propofol group (PG) and sevoflurane group (SG), with 45 patients in each group. Patients in PG were anesthetized with combination of propofol and remifentanil, while those in SG received combination of sevoflurane and remifentanil. Patients’ heart rate (HR), stroke volume (SV) and mean arterial pressure (MAP) were tested before anesthesia induction (T1), after intubation (T2), 15 min after pneumoperitoneum (T3), and after extubation (T4), in order to evaluate the stability of vital signs in the patients. 
 Results: At T2, T3, and T4, HR, SV, and MAP were more stable in SG than in PG (p < 0.05). At T3 and T4, the levels of ET-1, noradrenaline (NE) and cortisol (Cor) were significantly lower in SG than in PG (p < 0.05). Furthermore, postoperative recovery time, spontaneous breathing time, time taken to open the eyes under command, and orientation recovery time were shorter in SG than in PG (p < 0.05). After awakening, SG had significantly higher Ramsay score than PG (p < 0.05). 
 Conclusion: The combined use of sevoflurane and remifentanil for anesthesia in patients undergoing laparoscopic surgery results in stable vital signs, facilitates recovery after surgery, improve quality of recovery, and reduce stress response. Therefore, the combination anesthesia merits further mechanistic and large-scale investigation before clinical application.