Amit Dhungana, P. Baral, Satyendra N. Singh, B. Sah, A. Subedi, P. Thapa, Y. Trikhatri
{"title":"异丙酚-芬太尼全静脉麻醉与七氟醚-芬太尼平衡麻醉在腹腔镜胆囊切除术中血流动力学变化和恢复情况的比较","authors":"Amit Dhungana, P. Baral, Satyendra N. Singh, B. Sah, A. Subedi, P. Thapa, Y. Trikhatri","doi":"10.54530/jcmc.1109","DOIUrl":null,"url":null,"abstract":"Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy.\nMethods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile.\nResults: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value < 0.001).\nConclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"30 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY\",\"authors\":\"Amit Dhungana, P. Baral, Satyendra N. Singh, B. Sah, A. Subedi, P. Thapa, Y. Trikhatri\",\"doi\":\"10.54530/jcmc.1109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy.\\nMethods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile.\\nResults: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). 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引用次数: 0
摘要
背景:七氟醚和异丙酚被认为是腹腔镜手术的首选药物,因为它们诱导麻醉平稳,血流动力学稳定,恢复情况好,术后并发症少。本研究的目的是比较异丙酚与七氟醚麻醉在腹腔镜胆囊切除术中的血流动力学变化和恢复情况。方法:对132例18 ~ 65岁ASA-PS I、II期腹腔镜胆囊切除术患者进行单盲比较研究,采用计算机生成的随机数字表随机分为两组,每组66例,A组为异丙酚1.5 ~ 2.5 mg/kg IV,异丙酚100 ~ 200 mcg/kg/min IV, B组为七氟醚诱导,七氟醚维持肺泡最低浓度0.7 ~ 1.3。主要终点是血流动力学参数(心率、收缩压和舒张压、平均动脉压)和恢复情况。结果:两组患者术中心率和舒张压在任何时间均具有可比性,B组患者仅在插管后3、5分钟收缩压明显低于a组(p < 0.05)。B组患者睁眼时间(657.89±172.30 s vs 453.58±157.49 s)、服从命令时间(696.79±192.44s vs 481.06±164.96s)、拔管时间(706.41±166.27s vs 483.38±160.62s)均显著快于B组(p值< 0.001)。结论:异丙酚组与七氟醚组血流动力学变化相当,七氟醚组血流动力学恢复较快。
COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY
Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy.
Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile.
Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value < 0.001).
Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.