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

Abstract Background Laparoscopic surgery produces measurable effects on cardio-circulatory, respiratory and metabolic systems. Total intravenous anesthesia with propofol using target-controlled infusion technique guided by Bispectral Index monitoring ensures an optimum level of anesthesia. This study was designed to evaluate the hemodynamic changes with the use of BIS-guided TCI with propofol-fentanyl during either laparoscopic or open cholecystectomy. Methods Twenty-four ASA class I-II patients, scheduled for cholecystectomy under general anesthesia using BIS-guided TIVA with propofol-fentanyl delivered by TCI pump, were divided surgically into laparoscopic surgery group (LS group, n  = 12) and open surgery group (OS group, n  = 12). Hemodynamic data as well as stress hormones were measured at various time intervals. Results Within LS, there was rise of both cardiac output after abdominal insufflation ( p p p p p p p p Conclusion BIS-guided TCI anesthesia with propofol-fentanyl offers a good and safe anesthesia technique for patients undergoing either laparoscopic or open cholecystectomy. The hemodynamic stability guided by esophageal Doppler monitor makes it a very appealing choice.