Effects of different general anesthetic methods on systemic stress response in aged patients with hypertension undergoing laparuscopic cholecystectomy

Abstract

Objective To compare the effects of two different general anesthetic methods on the systemic stress response in aged patients with hypertension undergoing laparoscopic cholecystectomy. Methods Twenty-six ASA Ⅱ-Ⅲ aged patients with hypertension who undergoing laparescopic cholecystectomy were randomly divided into two groups, group Ⅰ (propofol TCI) and groupⅡ (propofol TCI plus isoflurane inhalation), all patients were induced with 2-3 μg/kg fcntanyl, 0.05 mg/kg midazolam,0.12 mg/kg vecuronium and 0.3 mg/kg etomidate. Anesthesia was maintained with different anesthetic methods. MAP, HR were recorded and blood samples were taken for the measurements of concentration of blood glucose (Glu), plasma epinephrine (E),ACTH and serum cortisol (Cor) before induce(T0),5 min before pneumoperitoneum(T1), 10 min after pneumoperitoneum(T2) and post-pneumoperitoneum(T3). Results MAP, HR in group Ⅱ were significantly lower than in group Ⅰ at T2,T3(P<0.05).GIu,E,ACTH and Cot were significantly higher in beth groups at T2,T3 than at TO ,compared with group Ⅰ, Glu,E,ACTH,Cor were significantly lower in group Ⅱ(P<0.05). Conclusion Compared with propofol TCI, propofol TCI plus isoflurane inhalation can relieve effectively the systemic stress response in aged patients with hypertension undergoing laparoscopie cholecystectomy. Key words: General anesthesia; Hypertension; Laparescopic; Cholecystectomy; Systemic stress response; Target-controlled infusion; Propofol; Isoflurane