摘要
Abstract
Objective To observe the changes of autonomic nervous function and stress response of elderly diabetic patients in laparoscopic cholecystectomy.Methods 40 elderly patients scheduled for selective laparoscopic surgery under general anesthesia were enrolled,aged from 65 to 79,ASA Ⅰ or Ⅱ,and were divided into 2 groups:observation group (patients with type Ⅱ diabetes) and control group (patients with no type Ⅱ diabetes),20 cases in each;the mean arterial pressure (MAP),heart rate (HR) as well as the related data of heart rate variability including low frequency power (LF),high frequency power (HF) and total spectral power (TP) were collected and recorded at each time point:after entering the operating room (T1),after intubation (T2),after pneumoperitoneum pressure reached stable (T3) and when suturing the skin after pneumoperitoneum finished (T4);blood glucose (GLU) and cortisol (COR) were measured and the occurrence of side effects,such as hypotension and sinus bradycardia,was observed and recorded.Results MAP and HR of the cases in observation group were lower within the time from T2 to T4 than those at T1,their levels of fasting blood glucose (FBG) before operation,the levels of GLU within the time from T1 to T4 and the occurrence of hypotension and sinus bradycardia were higher than those of the cases in control group;the GLU level of the cases in control group kept raising while that of the cases in observation group dropped down first and then kept going up;COR,LF,HF and TP of the cases in both groups at T2,T3 and T4 were lower than those at T1,keeping dropping down gradually,the difference between the 2 groups was of no statistical significance.Conclusion The autonomic nerve activity of the elderly people will be inhibited under anesthesia,and the elderly with diabetes are more likely to have hemodynamic disorders and glucose metabolic disorders;an appropriate anesthesia management can better control the impact of endotracheal intubation and surgical stress on the patientas.关键词
糖尿病/自主神经功能/心率变异性/应激反应Key words
diabetes mellitus/autonomic nervous function/heart rate variability/stress response
