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Feasibility analysis TCI etomidate perioperative adrenal function in elderly patient's anesthesia in elderly

Xin Li, Dan Yang, Yan Chen, Jiang Shen, Tao Hong

Objective: Feasibility analysis TCI etomidate elderly patients perioperative adrenal function in elderly anesthesia.

Methods: 60 patients undergoing general anesthesia patients were randomly divided into two groups figure that etomidate group and propofol group. All patients were using target-controlled infusion of intravenous anesthesia drugs, for two groups of patients after induction of anesthesia whichever venous blood samples. Until the patient is conscious, breathing normally pulls out after the endotracheal tube. Routine testing and record the ECG, heart rate, noninvasive blood pressure and transcutaneous oxygen saturation changes in two groups of patients; respectively before anesthesia (T0) , after anesthesia (T1) , before surgery, after surgery 24 h (T2-T4) five time points blood 3 ml, measured in patients with venous blood plasma cortisol, and the use of immunosuppressive biochemical reagents and electrochemical methods of measurement; the two groups were recorded during anesthesia and intensive care unit of adverse reactions.

Results: Compared with T0, two groups of serum cortisol levels in the process of induction of anesthesia and anesthesia are there different degrees lower, but are within the normal range, in which the lowest blood cortisol levels in patients with T3 moment, the difference statistically significant (P<0.05), while the content of other moments, although low, but there was no significant difference (P difference>0.05). Propofol group of patients with systolic blood pressure, diastolic blood pressure and heart rate were to be dropped after anesthesia, and the difference was statistically significant (P<0.05); etomidate group of patients with systolic blood pressure showed a tendency to gradually reduce its diastolic blood pressure at each time point was no statistical difference (P>0.05); and SPO₂ value anesthesia before the period was significantly increased compared with anesthesia, the difference was statistically significant (P<0.05). Two groups of patients with only a few patients during surgery side effects occur nausea, vomiting, etc., but its incidence were compared and found no statistically significant difference (P>0.05), but the two groups are present in 1 patient symptoms of sleepiness, both compared to extubation was no significant difference (P>0.05); there were no cases of the patients had intraoperative awareness.

Conclusions: TCI etomidate and propofol emulsion can better inhibit perioperative stress response, and the control in the normal range, and within 24 h after recovery to normal levels.