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| Effect of Different Anesthesia Methods on Maintenance of Anesthesia and Endothelial Cell Function in Laparoscopic Cholecystectomy |
| ZHANG Jing-yi, WEI Ning-hua |
| Department of Anesthesiology,The Second Affiliated Hospital of Xi'an Medical College,Shaanxi Xi'an 710038 |
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Abstract 【Objective】To observe the effect of different anesthesia methods on the maintenance of anesthesia and vascular endothelial function during laparoscopic cholecystectomy (LC).【Methods】A total of 78 patients who underwent LC in our hospital were divided into A Group (n=39) and B Group (n=39) by random number table. A group was anesthetized with propofol combined with remifentanil, and B group was anesthetized with sevoflurane. Anesthesia effects (induction time, extubation time, anesthesia recovery time) and vascular endothelial cell function such as peripheral blood P-selectin, intercellular adhesion molecule-1 (ICAM-1) and thrombomodulin (TM) were recorded and compared between the two groups. 【Results】The anesthesia induction time in A group were significantly higher than B group (P<0.01), while the extubation time, recovery time, and anesthesia recovery room stay time of A group were significantly lower than those of B group (P<0.01). The fluctuation range of blood pressure (MAP) and partial pressure of carbon dioxide (PaCO2) at 4 time points was smaller than B group (P>0.05). Levels of MAP and PaCO2 of patients in A group at 15 minutes of pneumoperitoneum were significantly lower than those in B group (P<0.01). After pneumoperitoneum, the PaCO2 of A group was significantly lower than B group (P<0.01). The plasma nitric oxide (NO) content of patients in A group was significantly lower than that in B group at 15 minutes of pneumoperitoneum (P<0.01), while at the same time plasma endothelin-1 (ET-1) content in group A was significantly higher than that in B group (P<0.01). P-selectin and TM in group A were significantly lower than those in B group at four times before pneumoperitoneum, at 15min of pneumoperitoneum and post-pneumoperitoneum, and the differences were statistically significant (P<0.01). There was no significant difference in ICAM-1 between two groups (P>0.05). 【Conclusion】The use of propofol combined with remifentanil for LC surgery will increase the induction time of anesthesia, while it had better intraoperative anesthesia effect to maintain the stability of hemodynamic indicators. At the same time, during the establishment of pneumoperitoneum, plasma NO concentration was increased, ET-1 level was decreased, and vascular endothelial cell function indicators P-selectin and blood ICAM-1 were decreased, which suggested LC had improved vascular endothelial cell function in patients.
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Received: 12 December 2020
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2022, Vol. 39 
