Key result
Laryngeal mask sevoflurane plus IV anesthesia speeds postoperative recovery and reduces myocardial injury markers versus control.
Why the study?
Acute cholecystitis combined with coronary heart disease is increasingly common in the elderly, making the selection of optimal laparoscopic anesthesia protocols an important clinical consideration.
Does sevoflurane laryngeal mask inhalation combined with intravenous anesthesia reduce perioperative stress response and myocardial injury compared to propofol-remifentanil intravenous anesthesia with tracheal intubation in elderly patients with acute cholecystitis and coronary heart disease?
RCT (n=72)
random number table method (1:1)
No
Does sevoflurane laryngeal mask inhalation combined with intravenous anesthesia reduce perioperative stress response and myocardial injury compared to propofol-remifentanil intravenous anesthesia with tracheal intubation in elderly patients with acute cholecystitis and coronary heart disease?
p-value: p=<0.05
Sevoflurane laryngeal mask inhalation combined with intravenous anesthesia attenuates perioperative stress and myocardial biomarker elevation while accelerating recovery in elderly patients with coronary heart disease undergoing laparoscopic cholecystectomy.
Supports use of sevoflurane laryngeal mask plus IV anesthesia in elderly CHD patients for laparoscopic cholecystectomy; extends RCT evidence on recovery and myocardial markers.
Surgery is the first choice for the treatment of acute cholecystitis. To ensure the curative effect of surgery, laparoscopic anesthesia should be characterized by rapid induction, good analgesic effect, and rapid postoperative sobriety. With the aggravation of an aging population, acute cholecystitis combined with coronary heart disease is more common in the elderly. The selection of anesthesia protocols for these patients has become a hot topic in research. In this study, we selected 72 elderly patients with acute cholecystitis combined with coronary heart disease who were treated in our hospital from January 2019 to January 2022 to explore the effects of sevoflurane laryngeal mask inhalation combined with intravenous anesthesia on perioperative stress and myocardial injury in elderly patients with acute cholecystitis combined with coronary heart disease, in order to provide a scientific basis for the formulation of a surgical plan for elderly patients with acute cholecystitis combined with coronary heart disease.
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Jin et al. (2022) conducted an RCT in Acute cholecystitis complicated by coronary heart disease (n=72). Sevoflurane laryngeal mask inhalation combined with intravenous anesthesia (remifentanil) vs. Intravenous general anesthesia with tracheal intubation (propofol 2 ug/kg induction and 0.2 mg/(kg·min) maintenance, remifentanil 200 ug/kg, vecuronium bromide 0.1 mg/kg) was evaluated on Perioperative anesthesia recovery times (orientation, spontaneous breathing, eye opening, speech response), hemodynamics (MAP, HR), stress response (serum cortisol, CRP), and myocardial injury markers (CK-MB, cTnI) up to 12 hours postoperatively (p=<0.05). Sevoflurane laryngeal mask inhalation combined with IV anesthesia significantly shortened recovery times and lowered postoperative cortisol, CRP, CK-MB, and cTnI levels compared to control (P<0.05).
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