Comparison of Effects of Propofol or Sevoflurane Combined with Remifentanil on Stress Response, Inflammatory Factors and Cerebral Oxygen Metabolism in Patients Undergoing Radical Esophagectomy

Abstract

Clinical studies have shown that reducing the stress response and catabolism in the perioperative period and strengthening perioperative nutritional support can help to improve the surgical outcome and promote postoperative recovery. However, there are few studies on the effects of general anesthesia maintenance drugs on the catabolism and nutritional status of patients undergoing surgery. Based on the above background, the purpose of this paper is to compare the effects of propofol or sevoflurane combined with remifentanil on stress response, inflammatory factors and cerebral oxygen metabolism in patients undergoing radical resection of esophageal cancer. 120 patients with elective esophageal cancer who underwent radical surgery from September 2016 to September 9, 2018 were randomly divided into group A and group B, with 60 cases in each group. Group A was given anesthesia with propofol and remifentanil, and group B was given anesthesia with sevoflurane plus remifentanil. Peripheral blood was measured before and after induction of anesthesia (T0), immediately after surgery (T1), and 12 hours after surgery (T2). Comparison of stress response indicators (cortisol (COR), adrenaline (NE), adrenaline (NA)), inflammatory factors [IL-8 (priming), interleukin-6 (IL-6), tumor necrosis (TNF) -α)]) and cerebral oxygen metabolism index [(intracervical venous blood oxygen saturation (SjvO 2 ), internal jugular venous oxygen partial pressure (PjvO 2 ), arterial oxygen saturation (SaO 2 ), arterial oxygen partial pressure (PaO 2 ))] difference. The levels of COR, NE, NA, IL-8, IL-6 and TNF-α in T1 and T2 peripheral blood were higher than those in T0, but in group A, COR, NE, NA, IL-8, IL-6 and TNF were observed. -α was significantly lower than group B (P < 0.05). The SjvO 2 , PjvO 2 , SaO 2 and PaO 2 of T1 and T2 in the two groups were lower than T0, but the SjvO 2 , PjvO 2 , SaO 2 and PaO 2 in group A were significantly lower than those in group B (P < 0.05). Compared with sevoflurane combined with remifentanil anesthesia, propofol combined with remifentanil anesthesia is more conducive to the stress response, reduction of inflammatory factors and improvement of cerebral oxygen metabolism in patients with radical esophageal cancer.