Objective To evaluate the effect of general intravenous anesthesia with propofol and remifentanil on the stress response caused by laparoscopic surgery.Methods A prospective,randomized,controlled study was performed.60 patients(ASAⅠ-Ⅱ) scheduled for laparoscopic surgery were randomly allocated into two groups,either receiving total intravenous anesthesia with propofol and remifentanil(group P/R) or balanced anesthesia with fentanyl and isoflurane(group I/F).Mean aterial pressure(MAP),heart rate(HR),auditory evoked potential index(AAI),peripheral sugar(Glu),plasma concentration of cortisol(Co) and norepinephrine(NE) at different time during anesthesia were recorded.Results There were no significant differences on AAI between two groups at all the time points.MAP and HR of group P/R were lower than those of group I/F at the time just after tracheal intubation and pneumoperitoneum((P<0.01).)The plasma concentration of Co and NE of group P/R were lower than those of group I/F at the time just after and 30()min after pneumoperitoneum(P <0.05).The Glu of group P/R were lower than that of group I/F 30()min after pneumoperitoneum and right after surgery(P <0.01).Conclusion Compared with the balanced anesthesia with fentanyl and isoflurane,general intravenous anesthesia with propofol and remifentanil can restrain the stress response caused by tracheal intubation and pneumoperitoneum more effectively during laparoscopic surgery. |
