Effect of general anesthesia combined with epidural anesthesia on tissue perfusion and intestinal barrier in elderly colorectal cancer patients undergoing radical resection
10.3760/cma.j.issn.0254-9026.2021.01.016
- VernacularTitle:全身麻醉联合硬膜外麻醉对老年结直肠癌根治术患者组织灌注及肠道屏障的影响
- Author:
Songmei MA
;
Li KONG
;
Chuanqi FANG
- From:
Chinese Journal of Geriatrics
2021;40(1):102-106
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of the combined general and epidural anesthesia on tissue perfusion and intestinal barrier in elderly patients undergoing radical resection of colorectal cancer.Methods:A total of 118 elderly patients with colorectal cancer admitted to our hospital from January 2018 to September 2019 were randomly divided into two groups: a single general anesthesia(control, n=59)and combined general and epidural anesthesia(observation, n=59). Two groups underwent radical resection of colorectal cancer.The perioperative parameters were compared between the two groups, including tissue perfusion[central venous-to-arterial carbon dioxide difference(Pcv-aCO 2), oxygen delivery index(DO 2I), oxygen consumption index(VO 2I), difference between central venous and arterial lactate(Dcv-aLac), oxygen extraction rate(O 2ER), central venous oxygen saturation(ScvO 2)], and intestinal barrier[diamine oxidase(DAO), D-lactic acid(D-Lac)]. Results:Compared with the control group, the ScvO 2 during T2-T4 periods was increased in the observation group, and the VO 2I, Dcv-aLac and Pcv-aCO 2 during T1-T4 periods were reduced in observation group( P<0.05). The DO 2I during T1-T4 periods was slightly higher in the observation group than in the control group, and the O 2ER was slightly lower in the observation group than in the control group, but the differences were not statistically significant, ( P>0.05). In the both two groups, the D-Lac and DAO levels showed a gradual upward trend during T1-T5 periods and a gradual downward trend during T5-T6 periods.The D-Lac and DAO levels during T2-T6 periods were lower in observation group than in the control group( P<0.05)[during abdominal exploration(T1); invitrolesion(T2); before abdominal closure(T3); after surgery(T4); postoperative day 1(T5); postoperative day 3(T6)]. Conclusions:General anesthesia combined with epidural anesthesia in elderly colorectal cancer patients undergoing radical resection can stabilize perioperative tissue perfusion, decrease intestinal barrier injury and increase anesthetic effect.
