Comparision of anesthesia with intravenous infusion of remifentanil-propofol versus isoflurane inhalation in patients undergoing laparoscopic cholecystectomy

Objective:To compare the effects and safety of anesthesia with intravenous infusion of remifentanil-propofol versus isoflurane inhalation.Methods:Forty patients undergoing elective laparoscopic cholecystectomy were randomly 1:1 assigned to one of two anesthesia maintenance groups:intravenous infu- sion with combination of remifentanil (0.5μg·kg~(-1).min~(-1)) with propofol (6 mg·kg~(-1)·h~(-1)) or inhalation with 2% isoflurance.The induced anesthesia was performed with midazolam 0.1 mg·kg~(-1),propofol 2 mg·kg~(-1),remifentanil 2μg·kg~(-1) and vecuronium 0.1mg·kg~(-1) in both groups.The anesthetic efficacy of the two groups was evaluated based on the SBP,DBP,HR and SPO_2 patients experienced before anesthesia,before pneumoperitoneum,at 5 min after pneumoperitoneum,at the end of pneumoperitoneum and at the end of operation.Other efficacy objectives included the time of endotracheal extubation,OAAS score after extuba- tion,pain and consciousness during operation,adverse events after operation.Results:No significant differ- ences in the time of endotracheal extubation and consciousness during the operation were found.The anesthesia-injected patients had higher OAAS scores after extubationa than anesthesia-inhaled patients (P＜0.05).Compared to the pre-anesthetic baseline,the SBP,DBP and HR at 5 min after pneumoperitoneum, at the end of pneumoperitoneum and at the end of operation showed higher values in the inhalation group (P＜0.05).No significant differences in the SBP,DPB and HR were found pre-and post-anesthetic treat- ment in the anesthesia-injected patients.The inhaled patients experienced significantly higher SBP,DBP and HR at 5 min after pneumoperitoneum,at the end of pneumoperitoneum and at the end of operation than the anesthesia-injected patients (P＜0.05).The common adverse events were nausea and vomiting,which had more incidences in the inhaled patients than the anesthesia-injected patients after operation (P＜0.05).Conclusion:The anesthesia with intravenous infusion of remifentanil plus propofol offers more he- modynamical outcomes and prognosis.