COMPARISON OF HAEMODYNAMIC CHANGES WITH PROPOFOL AND SEVOFLURANE ANAESTHESIA DURING LAPAROSCOPIC SURGERY

摘要

Sevoflurane is a useful alternative to propofol in providing anesthesia where rapid emergence and recovery of cognitive function are desired. In this randomized study, hemodynamic changes and recovery characteristics of sevoflurane anesthesia were compared with propofol anesthesia in fifty patients of America Society of Anesthesiology (ASA) Grade I and II undergoing laparoscopic surgeries of 1-2 hr duration. Injection fentanyl was used as an adjuvant to provide analgesia. In Group-I patients, anesthesia was induced with propofol-2 mg/kg i.v. and maintained with sevoflurane-N2O-O2 and injection vecuronium. The inspired concentration of sevoflurane was kept between 1 to 1.5%. In Group-II patients, anesthesia was induced with propofol-2 mg/kg i.v. and maintained with propofol infusion-N2O-O2 and injection vecuronium. Propofol infusion was given in a range of 75 to 125microgram/kg/min. Induction with propofol was without any untoward hemodynamic changes or episodes of coughing or laryngospasm. Mean heart rate during maintenance was much lower as compared to baseline in group-II than in group-I. There was no episode of sever bradycardia which needed treatment in any of the groups. The incidence of tachycardia could be controlled with increase in inspired concentration of volatile anesthetic agent. Fall in mean blood pressure was more in group-II than in group-I. No undesired event was noted intraoperatively in any group. There was no significant difference in the incidence of Post Operative Nausea and vomiting (PONV) in two groups. The use of sevoflurane resulted in greater hemodynamic stability while propofol caused reduction in heart rate and blood pressure. Also the use of sevoflurane resulted in faster emergence from anesthesia as compare to propofol.