Effect of anesthesia depth on stress response during single-lung ventilation in thoracic surgery
10.3760/cma.j.issn.1006-9801.2020.01.003
- VernacularTitle: 胸科手术单肺通气期间麻醉深度对应激反应的影响
- Author:
Xiaoyu WANG
1
;
Taotao XING
1
;
Guojie HAN
1
;
Yi LIU
2
;
Xiaoli AN
3
Author Information
1. Department of Anesthesiology, Shanxi Medical University, Taiyuan 030001, China
2. Department of Anesthesiology, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China
3. Department of Anesthesiology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
- Publication Type:Journal Article
- Keywords:
Surgical procedures, operative;
Monitoriry, intraoperative;
Stress;
Depth of anesthesia;
Bispectral index monitoring
- From:
Cancer Research and Clinic
2020;32(1):11-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effects of different anesthesia depths on stress response during single-lung ventilation in patients with thoracoscopic lobectomy.
Methods:Sixty patients selected for elective thoracoscopic lobectomy in the Second Hospital of Shanxi Medical University from September 2018 to May 2019 were randomly divided into three groups according to the digital random table method, with 20 patients in each group. Group A maintained deep anesthesia with the bispectral index (BIS) 36-45, group B maintained moderate anesthesia with BIS 46-55, and group C did not undergo BIS monitoring. The changes of heart rate, mean arterial pressure (MAP), stress indexes cortisol and blood glucose before anesthesia induction (T0), immediately after one-lung ventilation (T1), 60 min after one-lung ventilation (T2) and immediately after skin suture (T3) in the three groups were compared.
Results:The concentration of blood glucose in group A at T1, T2 and T3 was (5.28±0.49) mmol/L, (5.34±0.49) mmol/L and (5.40±0.47) mmol/L, and the cortisol was (142.75±31.45) ng/ml, (181.36±19.62) ng/ml and (153.81±33.92) ng/ml; the blood glucose in group B was (5.63±0.35) mmol/L, (6.06±0.19) mmol/L and (5.79±0.44) mmol/L, and the cortisol was (168.45±31.16) ng/ml, (171.09±25.28) ng/ml and (159.39±18.77) ng/ml; the blood glucose in group C was (6.35±0.56) mmol/L, (7.04±0.26) mmol/L and (6.17±0.54) mmol/L, and the cortisol was (191.13±46.00) ng/ml, (283.25±30.07) ng/ml and (183.01±19.71) ng/ml, respectively. The blood glucose and cortisol levels in group C at T1, T2 and T3 were higher than those in group A and group B (all P < 0.05). The MAP in group A at T1, T2 and T3 were (69±5) mmHg (1 mmHg= 0.133 kPa), (67±6) mmHg and (75±7) mmHg, respectively, and group B was (80±8) mmHg, (79±4) mmHg and (84±9) mmHg, the differences between the two groups were statistically significant (all P < 0.05). There was significant difference in cortisol between group A and group B at T1 (P < 0.05). The heart rate and MAP at T1, T2 and T3 in group A and group C were significantly different from those at T0 (all P < 0.05). The heart rate and MAP at T1 and T2 in groups B were significantly different from those at T0 (all P < 0.05).
Conclusion:BIS anesthesia depth monitoring should be performed during single-lung ventilation in thoracic surgery, and BIS should be maintained at 46-55, which can not only inhibit the stress response but also have a slight effect on hemodynamics.
