title: The Effects of Different Methods of Anaesthesia for Laparoscopic Radical Gastrectomy with Monitoring of Entropy.
abstract: To investigate the effects of methods of total intravenous anaesthesia (TIVA) and combined intravenous and inhaled anaesthesia (CIIA) for laparoscopic radical gastrectomy under the same anaesthetic depth monitored by entropy indices.
  
  
  
  One hundred patients undergoing laparoscopic radical gastrectomy were randomly distributed into group I (anaesthetized by TIVA) and group II (anaesthetized by CIIA), each group including 50 patients. TIVA was performed with propofol and remifentanil by means of target controlled infusion (TCI) for the patients in group I. CIIA was performed for patients in group II by inhalation of sevoflurane and continuous infusion of remifentanil after anaesthesia induction, with state entropy (SE) maintained in the range of 45-60 and difference regarding response entropy (RE) and SE less than 10.3. The concentrations of epinephrine, norepinephrine and dopamine in plasma from radial artery blood samples were measured and the durations of surgical operation, breathing recovery, extubation, awakening, and postoperative orientation recovery recorded; and 48 h postoperative adverse reactions at the following times: the time at which the patient becomes calm for 5 min after entering the operating theatre (T0); upon completion of pneumoperitoneum (PPT) (T1); 15 min after PPT (T2); intraoperative detection (T3), immediately after extubation (T4); and 15 min after extubation (T5).
  
  
  
  Comparing the measurements of epinephrine, norepinephrine and dopamine in plasma of the above two groups at the same time, the difference between the measurements at T0 and T2, and T5 were not statistically significant (p>0.05), whereas those at T1, T3, and T4 were statistically significant (p<0.05). Specifically, the measurements for group I were significantly higher than those for group II; the differences regarding the duration of breathing recovery, extubation, and awakening in both groups were not statistically significant (p>0.05). The postoperative orientation recovery duration for group II was significantly less than that that for group I (p<0.05); none of the patients in either group had intraoperative awareness, and the incidence of adverse reactions, such as nausea, vomit, and agitation in both groups was not statistically significantly different (p>0.05).
  
  
  
  At the same anaesthetic depth, the CIIA method outperforms the TIVA method in suppressing the stress response and obtaining smooth awakening after laparoscopic radical gastrectomy for patients with gastric cancer; therefore, the CIIA method has a better anaesthetic effect.
authors.affiliation: Department of Anesthesiology, Yuhuangding Hospital, Medical College, Qingdao University, Yantai, Shandong Province, P.R. China jahzy@126.com.
authors.forename: Aihua
authors.initials: A
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology, Yuhuangding Hospital, Medical College, Qingdao University, Yantai, Shandong Province, P.R. China.
authors.forename: Lin-Jing
authors.initials: LJ
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Yuhuangding Hospital, Medical College, Qingdao University, Yantai, Shandong Province, P.R. China.
authors.forename: Yu-Xia
authors.initials: YX
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Yuhuangding Hospital, Medical College, Qingdao University, Yantai, Shandong Province, P.R. China.
authors.forename: Ming-Chuan
authors.initials: MC
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Yuhuangding Hospital, Medical College, Qingdao University, Yantai, Shandong Province, P.R. China.
authors.forename: Yong-Bo
authors.initials: YB
authors.lastname: Ding
mesh_terms: D000368:Aged; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D019277:Entropy; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous
keywords: Entropy; general anaesthesia; laparoscope; pneumoperitoneum; stress