Comparison of Etomidate and Propofol in Laparoscopic Cholecystectomy

Feng Chaonan; Zhan Ying

Abstract：Objective To investigate perioperative effects of continuous intravenous pumping of etomidate on pa-tients undergoing laparoscopic cholecystectomy. Methods 60 patients underwent laparoscopic cholecystectomy were randomly divided into etomidate group(group E)and propofol group(group B)(n = 30). Sequential administration of midazolam 0. 05 mg/ kg,fentanyl 3 ~ 5 g/ kg,vecuronium 0. 1 ~ 0. 2 mg/ kg for anesthesia induction. Etomidate 0. 3 mg/ kg was given to group E and propofol 1 ~ 2 mg/ kg was given to group B. Anesthesia was malntalned with pumping remifentanil 5 ~ 15 g/ kg·h. Etomidate 0. 6 ~ 1. 2 mg/ kg·h was given to group E and propofol 6 ~ 10 mg/ kg·h was given to group B for malntenance. Vecuronium was added according to actual situation. Systolic blood pressure/diastolic blood pressure(SBP/ DBP),mean arterial pressure(MAP),heart rate( HR),oxygen saturation( SpO2 ) were recorded in the following time points:before anesthesia(T0 ),after induction of anesthesia(T1 ),immediately after intubation(T2 ),2 min after intubation(T3 ),abdominal inflation(T4 ),time of removing gallbladder(T5 )and after operation(T6 ). Concentration of plasma cortisol(Cor),aldosterone(ALD)and adrenocorticotrophic hormone (ACTH)were detected by chemiluminescence immunoassay in T0 ,T6 ,24 h after operation(T7 )and 48 h after oper-ation(T8 ). Venous blood samples were needed for the detection. Perioperative adverse reactions were observed and recorded. Results ①SBP,DBP and MAP decreased at T1(P < 0. 05). SBP,DBP and MAP in group B decreased significantly compared with those in group E(P < 0. 05). The highest and lowest SBP during induction and malnte-nance in group E were higher than those in group B(P < 0. 05). ②Concentrations of Cor and ACTH at T6 and T7 in group E decreased compared with those at T0(P < 0. 05),and returned to preoperative level at T8 . ③There was no significant difference in perioperative adverse reaction between two groups. Conclusion Etomidate can be used in general anesthesia induction and malntenance for patients underwent laparoscopic cholecystectomy. It can inhibit ad-renal cortex during malntenance of general anesthesia for short time,but still within the normal range and recover to the preoperative level after 48 h.