Objective To investigate the effect of propofol and sevoflurane on pancreatic function in patients undergoing laparoscopic myomectomy. Methods Sixty patients undergoing laparoscopic myomectomy from Septem-ber 2016 to October 2017 in Shenzhen Nanshan District Maternal and Child Health Hospital were selected and randomly divided into propofol group and sevoflurane group according to random number table, with 30 patients in each group. With propofol 2 mg/kg+rocuronium 0.9 mg/kg+sufentanil 0.5 μ g/kg for rapid induction, the patients in sevoflurane group received continuous inhalation of 2%-3% sevoflurane, and those in propofol group received continuous infusion of 4-12 mg/(kg·h) propofol. The levels of blood glucose, insulin, C peptide and glucagon, malondialdehyde (MDA), epi-nephrine (NE), norepinephrine (NA) were determined before induction (T0), at the beginning of the operation (T1), and at the end of operation (T2). The quality of anesthesia and adverse events were recorded. Results Levels of blood glu-cose, insulin, C peptide, glucagon, serum NE, NA, MDA levels of the two groups at different time points had statistically significant difference (P<0.05). Compared with T0, levels of blood glucose, glucagon, insulin, C peptide, serum NE, NA, MDA in the two groups increased significantly at T1 and T2 (P<0.05). Compared with the sevoflurane group, levels of blood glucose, glucagon were significantly lower in propofol group at T1 and T2, and insulin, C peptide, serum NE, NA, MDA were significantly higher (P<0.05). The sevoflurane group was lower than the propofol group in the time of disappearance of consciousness, the time of opening eyes, and the time of extubation (P<0.05), and there was no signifi-cant difference in adverse events between the two groups (P>0.05). Conclusion Propofol can promote the secretion of insulin and C peptide and reduce blood glucose concentrations during operation, and sevoflurane can inhibit the stress re-sponse and stabilize hemodynamics in the laparoscopic myomectomy operation. Narcotic drugs should be used in clini-cal practice according to the different needs of patients.%目的 探讨丙泊酚与七氟醚对腹腔镜下行子宫肌瘤切除术患者胰岛功能的影响.方法 选取2016年9月至2017年10月深圳市南山区妇幼保健院择期腹腔镜下行子宫肌瘤切除术患者60例,按随机数表法将患者分为七氟醚组和丙泊酚组,每组30例.两组患者均给予丙泊酚2 mg/kg+罗库溴铵0.9 mg/kg+舒芬太尼0.5 μg/kg进行快速诱导,七氟醚组采用七氟醚2%~3%持续吸入;丙泊酚组采用丙泊酚4~12 mg/(kg·h)持续泵注.诱导前(T0)、手术开始时(T1)、手术结束时(T2)采血测定血糖、胰岛素、C肽及胰高血糖素、丙二醛(MDA)、肾上腺素(NE)、去甲肾上腺素(NA)的浓度,记录麻醉质量和不良反应事件.结果 两组患者在不同时间点的血糖、胰岛素、C肽、胰高血糖素、血清NE、NA、MDA浓度比较差异均有统计学意义(P<0.05);与T0比较,两组患者T1、T2时的血糖、胰高血糖素、胰岛素、C肽浓度升高,血清NE、NA、MDA浓度也升高,差异均有统计学意义(P<0.05);与七氟醚组比较,丙泊酚组患者T1、T2时的血糖、胰高血糖素浓度较低,胰岛素、C肽浓度较高,血清NE、NA、MDA浓度也较高,差异均有统计学意义(P<0.05);七氟醚组患者的意识消失时间、睁眼时间、拔管时间均低于丙泊酚组,差异均有统计学意义(P<0.05);两组患者的不良反应发生率比较差异无统计学意义(P>0.05).结论 对于腹腔镜子宫肌瘤切除术患者,丙泊酚更能促进胰岛素和C肽的分泌,降低术中血糖浓度;七氟醚更能抑制应激反应,稳定循环血流动力学,临床需根据患者需求选用不同的麻醉药物.
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