Hemodynamic changes and stress response during BIS-guided TCI anesthesia with propofol-fentanyl in laparoscopic versus open cholecystectomy

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

able 1 Demographic features of the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
Age (yrs.)	34.83 ± 12.25	42.17 ± 16.19	0.224 (NS)
Sex (F/M)	9/3	8/4	0.653 (NS)
Weight (kg)	75.00 ± 8.79	76.67 ± 12.31	0.706 (NS)
Height (cm)	165.42 ± 4.98	167.50 ± 6.57	0.391 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

able 2 Comparison between mean values of cardiac output (CO) (l min⁻¹) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	4.98 ± 1.21	5.39 ± 1.54	0.468 (NS)
T1	4.93 ± 1.65	5.27 ± 1.54	0.614 (NS)
T2	5.60 ± 1.93	5.04 ± 1.30	0.415 (NS)
T3	6.01 ± 2.07^a	5.03 ± 1.53	0.200 (NS)
T4	5.27 ± 1.49	5.17 ± 1.45	0.869 (NS)
T5	5.14 ± 1.33	5.03 ± 1.50	0.853 (NS)
T6	6.09 ± 1.63^aa	4.90 ± 1.70	0.094 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

p < 0.05 relative to T0 within the same group.

a p < 0.01 relative to T0 within the same group.

able 3 Comparison between mean values of stroke volume (SV) (ml) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	67.92 ± 19.13	67.50 ± 19.55	0.958 (NS)
T1	61.83 ± 20.62	62.75 ± 19.57	0.912 (NS)
T2	62.42 ± 22.94	61.75 ± 20.06	0.940 (NS)
T3	68.17 ± 24.77	65.00 ± 23.39	0.751 (NS)
T4	68.17 ± 19.72	66.08 ± 19.02	0.795 (NS)
T5	68.58 ± 18.89	66.75 ± 18.72	0.814 (NS)
T6	77.00 ± 22.23^a	71.42 ± 20.91	0.533 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

p < 0.05 relative to T0 within the same group.

able 4 Comparison between mean values of mean arterial blood pressure (MAP) (mmHg) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	104.05 ± 10.05	100.51 ± 12.09	0.444 (NS)
T1	80.08 ± 7.56^aa	86.55 ± 7.66^aa	0.049^∗
T2	93.86 ± 16.53	89.11 ± 21.91	0.555 (NS)
T3	92.86 ± 15.48^a	88.94 ± 13.89^aa	0.521 (NS)
T4	96.49 ± 15.36	99.00 ± 13.65	0.676 (NS)
T5	96.51 ± 14.74	99.19 ± 11.02	0.618 (NS)
T6	98.81 ± 14.10	98.05 ± 12.60	0.894 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

p < 0.05 relative to T0 within the same group.

a p < 0.01 relative to T0 within the same group.

p < 0.05 between the two groups at the same timing.

able 5 Comparison between mean values of systemic vascular resistance (SVR) (dynes sec⁻¹ cm⁻⁵) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	1664.94 ± 336.01	1558.23 ± 567.64	0.581 (NS)
T1	1316.92 ± 517.69^a	1302.88 ± 428.58^aa	0.943 (NS)
T2	1370.06 ± 475.96^a	1380.53 ± 523.60	0.960 (NS)
T3	1184.84 ± 320.79^aa	1370.74 ± 508.07	0.295 (NS)
T4	1351.58 ± 348.19^aa	1460.69 ± 507.66	0.546 (NS)
T5	1400.29 ± 366.28^aa	1520.16 ± 452.98	0.483 (NS)
T6	1294.13 ± 349.56^aa	1511.86 ± 768.29	0.381 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

p < 0.05 relative to T0 within the same group.

a p < 0.01 relative to T0 within the same group.

able 6 Comparison between mean values of stroke distance (cm) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	17.08 ± 4.36	15.29 ± 3.98	0.307 (NS)
T1	15.50 ± 5.02	14.38 ± 4.04	0.555 (NS)
T2	16.30 ± 4.33	14.93 ± 4.37	0.447 (NS)
T3	16.33 ± 5.56	15.32 ± 5.67	0.664 (NS)
T4	16.61 ± 5.40	15.25 ± 5.07	0.532 (NS)
T5	16.44 ± 5.26	15.31 ± 5.49	0.611 (NS)
T6	19.41 ± 6.85	15.98 ± 6.41	0.219 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

able 7 Comparison between mean values of minute distance (cm) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	1394.42 ± 342.48	1235.17 ± 325.50	0.255 (NS)
T1	1486.50 ± 481.82	1255.00 ± 415.28	0.221 (NS)
T2	1654.83 ± 632.68	1293.92 ± 629.57	0.175 (NS)
T3	1573.75 ± 527.91	1219.58 ± 579.45	0.132 (NS)
T4	1538.00 ± 504.38	1245.33 ± 507.82	0.171 (NS)
T5	1482.50 ± 461.40	1160.50 ± 454.72	0.099 (NS)
T6	1730.58 ± 495.74^aa	1281.08 ± 559.93	0.049^∗

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

a p < 0.01 relative to T0 within the same group.

p < 0.05 between the two groups at the same timing.

able 8 Comparison between mean values of mean acceleration (cm sec⁻²) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	9.70 ± 2.36	8.93 ± 2.29	0.425 (NS)
T1	10.88 ± 3.92	9.41 ± 4.69	0.414 (NS)
T2	11.09 ± 3.46	9.57 ± 3.59	0.303 (NS)
T3	10.75 ± 3.62	9.00 ± 3.32	0.229 (NS)
T4	11.29 ± 3.93	9.38 ± 3.36	0.215 (NS)
T5	10.98 ± 4.03	9.23 ± 3.47	0.269 (NS)
T6	10.71 ± 3.63	8.99 ± 2.86	0.212 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

able 9 Comparison between mean values of flow time corrected (msec) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	359.33 ± 30.62	367.08 ± 32.09	0.551 (NS)
T1	348.17 ± 41.72	369.17 ± 24.44	0.147 (NS)
T2	356.17 ± 41.86	364.08 ± 23.72	0.574 (NS)
T3	374.50 ± 36.49	357.08 ± 37.99	0.264 (NS)
T4	364.00 ± 37.43	376.33 ± 26.68	0.363 (NS)
T5	378.33 ± 31.64	366.58 ± 19.51	0.285 (NS)
T6	397.33 ± 24.71^aa	359.00 ± 26.19	0.001^∗∗

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

a p < 0.01 relative to T0 within the same group.

* p < 0.01 between the two groups at the same timing.

able 10 Comparison between mean values of heart rate (beat min⁻¹) measured at various timings of anesthesia in the two studied groups.

	Laparoscopy group (n = 12)	Open surgery (n = 12)	p value
T0	87.50 ± 14.39	89.00 ± 15.90	0.811 (NS)
T1	81.50 ± 10.98	86.75 ± 18.55	0.408 (NS)
T2	82.33 ± 12.46	87.67 ± 16.11	0.374 (NS)
T3	81.58 ± 12.11	82.42 ± 11.88	0.866 (NS)
T4	83.17 ± 11.84	80.33 ± 13.40^a	0.589 (NS)
T5	83.17 ± 15.32	81.42 ± 11.91^a	0.758 (NS)
T6	78.50 ± 12.15^a	80.00 ± 11.39^a	0.758 (NS)

Data are expressed as mean ± SD.

NS = p > 0.05 = not significant.

p < 0.05 relative to T0 within the same group.

igure 1 Comparison between mean norepinephrine (NE) levels at various timings of anesthesia in the two studied groups. ^∗∗p < 0.01, ^∗∗∗p < 0.001 as compared to T0.

igure 2 Comparison between mean epinephrine (E) levels at various timings of anesthesia in the two studied groups. ^∗∗∗p < 0.001 as compared to T0.

igure 3 Comparison between mean cortisol levels at various timings of anesthesia in the two studied groups. ^∗∗∗p < 0.001 as compared to T0.

igure 4 Comparison between mean ACTH levels at various timings of anesthesia in the two studied groups. ^∗∗∗p < 0.001 as compared to T0.