Comparison Of Reminfentanil Combined Sevoflurance Or Isoflurance In Geriatric Patients Undergoing Laparoscopic Cholecystomy

Objective: To compare the effects of sevoflurance and isoflurance combined reminfentanil anesthesia in geriatric patients receiving laparoscopic cholecystomy,which included hemodynamic parameters changes,postoperative recovery time,congnitive functions and the side effects. Method: 60 geriatric ASA 1-2 patients undergoing laparoscopic cholecystomy were randomly divided into two groups(n=30).two groups received the same pre-medication and induction medicine.Both groups continously receiving reminfentanil(0.15ug/kg/min) by using a microinfusion pump and inhaling sevoflurance and isoflurance with its expired concentration at 0.6 minimum alveolar concentration. AAI values were continously monitored.The systolic blood pressure (SBP),diastolic blood pressure(DBP)and heart rate(HR) ,AAI were recorded before operation,operation starting,and the time of 1min,5min after CO2 insufflation and operation end .Observing recovery time ,extubation time , valuing sedation score(OAAS),testing cognitive functions(MMSE),and the incidence of hypertensive or hypotensive and the side effects were recorded during the operation. Results: There were no significant differences in the changes of HR and NIBP in both groups(p>0.05).But hypertensive fluctuation was statistically less during the maintain of operations in sevoflurance group compared with isoflurane group, but there were no differences in DBP and HR. The trend of AAI changes was same in two groups .But there was a significant defference of AAI value during the analepsia time(p<0.05) in sevoflurane group as compared with isoflurane group.The recovery time ,extubation time,OAAS score, MMSE recovery after extubation had significant deviation(p<0.05).Conclusion: Both groups provided satisficatory anesthesia for laparoscopic cholecystomy,and there were similar tendency of the hemodynamic parameters changes and AAI value in two groups.But the sevoflurance group recovery time, extubation time,and the MMSE recovery were more shorter in sevoflurance group compared with isoflurance group.