Effects of target controlled infusion on the stress reaction of patients underwent laparoscopic cholecystectomy

Objective To explore the effects of target controlled infusion(TCI) of propofol combined with remifentanil on the stress reaction of patients underwent laparoscopic cholecystectomy.Methods Totally 90 patients underwent laparoscopic cholecystectomy were divided into group A,B,C.TCI of 3 μg/mL propofol and 3 ng/mL remifentanil was applied in group A,TCI of 3 μg/mL propofol in group B and 0.2~0.6 mg·kg-1·h-1 propofol through the venous pump in group C.The heart rate(HR),mean arterial pressure(MAP),arterial oxygen saturation(SpO2),end-tidal pressure of carbon dioxide(PETCO2),and the levels of corticosteroid(COR),interleukin-6(IL-6),C-reaction protein(CRP),blood glucose(GLU) were analyzed and compared at different time points of before the anesthesia(T0),after the induction(T1),30 minutes after the pneumoperitoneum(T2),operation finished(T3) and 24 hours after the operation(T4).Results There was no significant difference in HR,MAP,SpO2,PETCO2 during the anesthesia between group A and B(P0.05).The HR in group C was increased but MAP was decreased after the anesthesia.SpO2 was obviously lowered at T1 and T2 compared with that at T0 in group C and the PETCO2 was increased at T1~T4 compared with that at T0(P0.05).There were obvious differences in HR and MAP at T1~T4 between group A and group C(P0.05).SpO2 was obviously higher at T1 and T2 and PETCO2 was lower at T1~T3 between group A and group C(P0.05).The levels of COR,IL-6,CRP,and GLU were not changed in group A,but increased in group B at T2~T4 compared with that at T0(P0.05),and obviously up-regulated in group C at T1~T4(P0.05).There were obvious differences between group A and group B and C at T2 and T3 in the levels of IL-6,CRP,and GLU(P0.05).The palinesthesia time of group A was obviously less than that in group B and C(P0.05).The ratio of nausea and vomiting postoperation of group A(12.50%)was lower than that of group B(23.08%) and C(33.33%),P0.01.Conclusion TCI of propofol combined with remifentanil can maintain the stable hemodynamics,decrease the injury of CO2 pneumoperitoneum and the stress reaction.It is a safe and anesthesia method for laparoscopic cholecystectomy with fast palinesthesia and fewer complications.