The Effects Of Sevoflurane, Propofol Or Etomidate On Stress Response Of The Elderly Patients During The Induction Of Anesthesia

Objective: To study the effects of sevoflurane,propofol or etomidate on hemodynamics, blood glucose and hydrocortisone of the elderly patients during the induction of anesthesia, and to discuss the effects of them on stress response .Method: Select ASAⅡ-Ⅲclass 45 elderly cases which select stomach, colorectal et al abdominal surgery, were randomly divided into three groups, 15 cases in each group. Etomidate intravenous induction group (group E), Propofol intravenous induction group (group P), Sevoflurane inhalation induction group (group S). To observe the body move and cough of three groups during intubation and record systolic blood pressure(SBP), diastolic blood pressure (DBP), heart rate(HR), pulse oxygen saturation(SPO2) before induction (T0), immediately after the induction before intubation (T1), after intubation 1min (T2), 3min (T3), 10min(T4), 30min(T5), and take the patients blood and measure blood glucose and plasma hydrocortisone concentrations before induction (T0), after intubation 3min (T3), after intubation 10min (T4), after intubation 30min (T5).Results: group E: compared with T0, the SBP and DBP of T1, T4, T5 point decreased significantly (Ρ<0.05), the HR of T1 point decreased, there was a significant difference (Ρ<0.05), the SBP, DBP and HR of T2 point increased, there was a significant difference (Ρ<0.05); group P: compared with T0, the SBP and DBP of T1, T3, T4, T5 point decreased significantly (Ρ<0.05), the HR of T1 point decreased significantly (Ρ<0.05); group S: compared with T0, the SBP and DBP of T1, T4, T5 point decreased significantly (Ρ<0.05), the HR of T1, T3, T4, T5 point lowered, there was a significant difference (Ρ<0.05). Compared with the group E, group P: the SBP and DBP of T1, T2, T3 point decreased significantly (Ρ<0.05), the HR of T2 point in group P decreased significantly (Ρ<0.05); group S: the SBP and DBP of T2 point decreased significantly (Ρ<0.05), the HR of T2, T3, T4, T5 point decreased significantly (Ρ<0.05). Compared with the group P, group S: the SBP, DBP of T2 point increased, there was a significant difference (Ρ<0.05), the HR of T3, T4, T5 point decreased significantly(Ρ<0.05). Compared the blood glucose concentration of three groups in group and inter-group, there was a significant difference(Ρ<0.05). Compared the plasma hydrocortisone concentration in three groups, compared with T0, which of T3, T4, T5 point decreased, there was a significant difference between group P and group S (Ρ<0.05). Compared with the group E, the plasma hydrocortisone concentration of T3, T4, T5 point decreased in group P and group S, there was a significant difference(Ρ<0.05).Conclusion: During induction of anesthesia in the elderly patients, on inhibiting the stress response of intubation, intravenous injection propofol 1.5mg/kg or inhalation sevoflurane 6% were better than intravenous injection etomidate 0.3mg/kg. sevoflurane and propofol could be also suitable induction of anesthesia for the elderly patients.