Correlation between postoperative stress level and sufentanil dosage in breast cancer patients
10.3760/cma.j.cn115807-20250709-00205
- VernacularTitle:乳腺癌患者术后应激水平与术中舒芬太尼药物用量的相关性分析
- Author:
Huiyu YUE
1
;
Wenjuan BAI
;
Leina HOU
Author Information
1. 陕西省肿瘤医院麻醉科，西安 710043
- Publication Type:Journal Article
- Keywords:
Breast cancer;
Stress level;
Sufentanil;
Drug dosage;
Relevance
- From:
Chinese Journal of Endocrine Surgery
2025;19(5):693-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Investigating the correlation between postoperative stress levels and intraoperative sufentanil dosage in breast cancer patients.Method:A retrospective selection was made of 100 BC patients who underwent surgery at Shaanxi Cancer Hospital from Apr. 2023 to Apr. 2025 as the research subjects. According to the dosage of sufentanil during the operation, they were divided into low-dose ( n=33), medium-dose ( n=34), and high-dose ( n=33) groups. The general data and postoperative stress levels of the three groups were compared and analyzed. Based on the results of stress levels, BC patients were further divided into the normal group ( n=75) and the elevated group ( n=25). The clinical data, laboratory indicators, and intraoperative sufentanil dosage of the two groups were compared and analyzed. Binary Logistic regression was used to analyze the factors influencing the postoperative stress level of patients, and a nomogram was constructed. ROC and DCA were used to analyze the predictive value and net benefit of the nomogram. Pearson correlation analysis was used to analyze the correlation between the factors influencing the stress state of patients and the postoperative stress level. Results:The levels of endothelin-1 (ET-1), norepinephrine (NE), and cortisol (Cor) in the high-dose group after surgery were significantly lower than those in the low-dose group and the medium-dose group ( t=9.55, 11.07, 82.91, P<0.05). The stress levels and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF), and adrenocorticotropic hormone (ACTH) in the stress group were significantly higher than those in the normal group. However, the levels of sufentanil drug, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were lower than those in the normal group ( t=2.02, 2.04, 2.15, P<0.05). Multivariate analysis of binary logistic regression showed that the dosage of sufentanil ( t=2.02, 2.04, 2.15, P<0.05) ; Multivariate analysis of binary logistic regression showed that sufentanil dosage ( OR=0.58, 95 %CI: 0.24-0.93), SOD ( OR= 0.63, 95 %CI:0.41~0.84) were protective factors, and ACTH ( OR=1.57, 95%CI:1.23-1.92), CRP ( OR=1.53, 95 %CI: 1.06-2.00) 、BDNF ( OR=1.43, 95 %CI:1.11-1.75) were risk factors affecting the stress state of patients ( P<0.05) ; The construction of a risk nomogram model based on the above influencing factors and the ROC analysis indicated that its AUC=0.829, indicating a good predictive ability. The correction curve is close to the ideal curve, indicating that the model has good discrimination and consistency. DCA curve verification revealed that its predicted probability was 68%, indicating a positive net benefit. Correlation analysis showed that the intraoperative sufentanil dose, SOD, ACTH, CRP, BDNF were significantly correlated with the postoperative stress level-related indicators NE, ET-1, Cor. Among them, the intraoperative sufentanil dose and SOD were negatively correlated with NE, ET-1, Cor, while the other indicators were positively correlated with them ( P<0.05) . Conclusions:High levels of ACTH, CRP and BDNF are independent risk factors for postoperative stress in patients with BC, while sufentanil fibroids and SOD during the operation are protective factors. Moreover, the intraoperative sufentanil dose has a significant correlation with the related indicators of emergency levels. Clinically, this can be used as a biomarker for predicting postoperative stress in patients with BC and individualized intervention measures can be implemented, providing a new monitoring perspective for clinical prediction of the occurrence of stress.
