Effect Of Alfentanil On Intraoperative Hemodynamics Inflammatory Response In Patients Undergoing Laparoscopic Cholecystectomy

Objectives In this study,patients with laparoscopic cholecystectomy were selected,anesthetic drugs were selected for alfentanil,and the changes in intraoperative hemodynamics of patients,as well as the changes of inflammatory factors IL-6,TNF-αand inflammatory index CRP,and the effect of alfentanil on hemodynamics and inflammatory response was discussed,which provided a theoretical basis for the clinical application of alfentanil.Methods From December 2020 to June 2021,a total of 40 patients underwent laparoscopic cholecystectomy at Tangshan Gongren Hospital.In accordance with the random number table method,these subjects were apart into two groups including a control group（group F）and an experimental group（group A）.Group A was induced by alfentanil and group F was induced by fentanyl.All patients need to fast for 6 hours before surgery and water for 4 hours.The patient entered the operating room to open the venous access of the upper limb,and oxygen inhalation,electrocardiogram,blood pressure and pulse oxygen saturation were monitored.Anesthesia induction:experimental group,alfentanil 20μg/kg,midazolam 0.1mg/kg,propofol 2mg/kg;control group,fentanyl 5μg/kg midazolam0.1mg/kg,propofol 2mg/kg.Record the baseline level of each parameter,after the patient lost consciousness,inject rocuronium 0.6 mg/kg.After achieving the optimal conditions for intubation（jaw relaxation,loss of eyelash reflex,and apnea）,endotracheal intubation was performed.Establishment of carbon dioxide pneumoperitoneum after stable breathing（pneumoperitoneum pressure is 12mm Hg）.Patients undergo laparoscopic cholecystectomy.Maintenance of anesthesia:experimental group,continuous infusion of propofol 4-12mg/（kg·h）and alfentanil 1μg/（kg·min）;control group,continuous infusion of propofol 4-12mg/（kg·h）.The bispectral index of EEG（BIS）was maintained at 40-60 by the anesthesia depth detector.Additional fentanyl at 4μg/kg for 30 minutes.Addition of rocuronium on demand during operation.Stop the maintenance drug at the end of the operation,wait for the patient to regain consciousness,breathe well on his own,recover muscle strength and meet the conditions of extubation,and then pull out the tracheal catheter.After extubation,patients were sent to the anesthesia recovery room.Postoperative analgesia:Patient-controlled intravenous analgesia（PCIA）was adopted in the analgesic prescription of both groups.The mean arterial pressure（MAP）and heart rate（HR）before anesthesia induction（T₀）,during intubation（T₁）,after pneumoperitoneum（T₂）,and during extubation（T₃）were observed and recorded.A total of 3 ml peripheral venous blood samples were collected at four time points:before anesthesia induction（T₀）,2 min after intubation（T₄）,20 min after pneumoperitoneum（T₅）,and after the operation（T₆）.IL-6,TNF-α,and CRP were detected by enzyme-linked immunosorbent assay（ELISA）.The operation time and anesthesia time of the two groups were counted.Results 1 There was no significant difference in the general situation of the two groups:age（years）,body mass index（BMI）,operation time（min）,and anesthesia time（min）（P>0.05）.2 Comparison of MAP,HR between the two groups:between groups,the MAP,HR of the two groups at the T₀time point was not statistically significant（P>0.05）,and the difference was statistically significant compared with the three time points of T₁to T₃in the two groups（P<0.05）.Compared with T₀,the experimental group T₁-T₃MAP,HR did not change significantly,and the difference was not statistically significant（P>0.05）,while the control group T₁-T₃MAP,HR was increased,and the difference was statistically significant（P<0.05）.3 Comparison of IL-6,TNF-α,and CRP concentrations at different time points in the two groups of patients.The concentrations of IL-6,TNF-αand CRP in the two groups were not statistically significant（P>0.05）in the T₀time point,and the concentrations of IL-6,TNF-αand CRP in the three time points of T₄,T₅and T₆were significantly lower than those in the control group（P<0.05）.Intra-group comparison:Compared with the T₀time point,the concentrations of IL-6,TNF-αand CRP in the three time points of T₄,T₅and T₆were increased in the two groups,and the difference was statistically significant（P<0.05）.ConclusionsAlfentanil for laparoscopic cholecystectomy patients can maintain intraoperative hemodynamic stability,reduce the inflammatory response,inhibit inflammatory factors.Figure5;Table3;Reference 126...