Comparison of perioperative cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer under different general anesthesia protocols
10.3760/cma.j.issn.0254-1416.2011.08.001
- VernacularTitle:不同全麻下腹腔镜结肠癌切除术病人围术期细胞免疫功能的比较
- Author:
Qiaoling ZHOU
;
Hua LIANG
;
Hongzhen LIU
;
Chengxiang YANG
;
Ping XIAO
;
Hanbing WANG
;
Zhihui YANG
- Publication Type:Journal Article
- Keywords:
Anesthesia,general;
Immunity,cellular;
Laparoscopy;
Colectomy
- From:
Chinese Journal of Anesthesiology
2011;31(8):909-912
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo compare the effects of different general anesthesia protocols on perioperative cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer.MethodsNinety ASA Ⅰ or Ⅱ colorectal cancer patients aged 40-64 yr weighing 50-85 kg undergoing laparoscopic surgery were randomly divided into 3 groups (n = 30 each):group total intravenous anesthesia (group Ⅰ ); group inhalational anesthesia (group Ⅱ ) and group combined intravenous-inhalational anesthesia(group Ⅲ ).Anesthesia was induced with iv midazolam,sufentanil,TCI of propofol and remifentanil and vecuronium in groups [ and Ⅲ.In group Ⅰ anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecuronium,while in group Ⅲ with inhalation of sevoflurane and intermittent iv boluses of vecuronium.In group Ⅱ anesthesia was induced and maintained with inhalation of sevoflurane and intermittent iv boluses of vecuronium.Narcotrend index was used to monitor depth of anesthesia and maintained at 37-64 during operation.Venous blood samples were taken for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+ ) and natural killer cells at 30 min before induction of anesthesia (T0 ),2 h after skin incision (T1),at the end of operation (T2 ) and 24 hafter operation (T3 ).ResultsThe levels of CD3+,CD4+,CD4+/CD8+ and natural killer cells were significantly decreased at T2 in group Ⅱ,while the levels of natural killer cells were decreased at T2 in group Ⅲ as compared with the baseline at T0,and were significantly lower than those in group Ⅰ.The levels of CD3 + and CD4+were significantly lower at T2 in group Ⅱ than in group Ⅲ.ConclusionIntravenous anesthesia with midazolam,propofol,sufentanil,remifentanil and vecuronium has less inhibitory effect on perioperative cellular immune function than inhalational anesthesia and combined intravenous-inhalational anesthesia in patients undergoing laparoscopic surgery for colorectal cancer.