Effects Of Different Prohibited Liquid Stste On Stress Response Of Tracheal Intubation In Laparoscopic Cholecystectomy

Objective:To observe the effects of different fluid states on the changes of blood pressure,heart rate,blood glucose and norepinephrine in patients undergoing laparoscopic cholecystectomy before induction of anesthesia、before and during intubation and 5 minutes after intubation.To understand the effects of different abstinence states on the stress response of patients under general anesthesia in laparoscopic cholecystectomy,so as to provide a more appropriate choice for reducing the stress response of patients under anesthesia.Methods:A total of 60 patients with laparoscopic cholecystectomy in the first general surgery department of handan central hospital were selected.The patients were randomly divided into three groups:The control group（fasting for 8 hours and drinking for 6 hours）had 20 patients.Clear water group（250ml clear water was drunk 2 hours before operation）had 20patients.Nutrient solution group（250ml nutrient solution two hours before surgery）had 20 patients.Blood pressure,heart rate,blood glucose and norepinephrine levels were compared between the three groups before induction of anesthesia（T₀）,before intubation（T₁）,immediately after intubation（T₂）,and 5 minutes after intubation（T₃）.SPSS22.0 statistical software was used for data analysis,and Logistic regression analysis was used to determine the factors affecting the changes of patients’average arterial pressure,heart rate,blood glucose and norepinephrine levels before and during intubation and 5 minutes after intubation.P<0.05 was considered statistically significant.Results:Compared with T₀、T₁and T₂,the mean arterial pressure（MAP）of T3 in the control group was relatively low（P<0.05）,and the difference was statistically significant.The heart rate of T₀～T₃in the control group changed rapidly（P<0.05）,and the difference was statistically significant.T₀～T₃,significant changes in blood glucose were observed in the control group and the clear water group（P<0.05）,and the difference was statistically significant.Compared with T₀and T₁,norepinephrine（NE）of T₂and T₃in the control group changed significantly（P<0.05）,and the difference was statistically significant.Compared with the control group,the average arterial pressure（MAP）in T₂and T₃of the clear water group and the nutrient solution group was higher than that of the control group（P<0.05）,and the difference was statistically significant.Compared with the control group,the heart rate（HR）of the T₀～T₃water group and the nutrient solution group was lower than that of the control group（P<0.05）,and the difference was statistically significant.Compared with the control group and the clear water group,the blood glucose in the nutrient solution group was higher than that in the control group and the clear water group（P<0.05）,and the difference was statistically significant.Compared with the control group,norepinephrine content was lower in the water group and nutrient solution group at T₀、T₁and T₂time（P<0.05）,and the difference was statistically significant.Multivariate Logistic regression analysis showed that changes in average arterial pressure（MAP）,heart rate（HR）,blood glucose（Glu）,and noradrenaline（NE）levels before and during intubation and 5 minutes after intubation were associated with preoperative drinking status（P<0.05）.Conclusions:In summary,drinking 250ml nutrient solution 2 hours before surgery has less impact on the physiological level of patients under general anesthesia after laparoscopic cholecystectomy.Drinking 250ml nutrient solution 2 hours before surgery had less effect on the stress response of patients undergoing laparoscopic cholecystectomy under general anesthesia.Drinking 250ml nutrient solution 2 hours before surgery can bring blood glucose closer to physiological level in patients under general anesthesia during laparoscopic cholecystectomy.