Effect of propofol on immune function, stress response and hemodynamics in patients undergoing colorectal cancer surgery

摘要

cqvip:Objective:To investigate the effects of propofol on immune function, stress response and hemodynamics in patients undergoing colorectal cancer surgery.Methods: 90 patients who were undergoing laparoscopic radical resection of colorectal cancer were randomly divided into propofol group (n=45) and sevoflurane group (n=45). The propofol group was anesthetized with propofol and the control group was given the same dose of sevoflurane. Changes in HR, SBP and DBP were observed before anesthesia, 1 h after induction, and at the end of surgery. The levels of CD19+, NK cells, MDA, SOD, insulin and cortisol were measured before anesthesia, at the end of operation and 24 h after operation.Results: Compared with before anesthesia, the levels of HR, SBP and DBP decreased at 1 h after induction (allP<0.05). At the end of the surgery, HR, SBP, and DBP returned to pre-anesthesia levels in both groups. The levels of HR, SBP and DBP in the propofol group were (74.56±7.55) times/min, (108.34±10.71) mmHg and (76.35±7.65) mmHg were higher than those in the sevoflurane group (allP<0.05). Compared with before anesthesia, CD19+ and NK cell ratio decreased at the end of surgery and 24 h after surgery, while MDA level increased at the end of surgery and 24 h after surgery (P<0.05). At the end of the propofol group, the proportion of CD19+and NK cells were (7.23±0.83)% and (15.17±1.21)% ,which were higher than the sevoflurane group (allP<0.05). At 24 h after surgery, the proportions of CD19+ and NK cells in the propofol group were (9.68±0.96) % and (19.58±1.86)%, which were higher than those in the sevoflurane group (all P<0.05). Compared with before anesthesia, MDA levels increased and SOD levels decreased at the end of surgery (P<0.05). At the end of the propofol group, the MDA level was (6.15±0.62) mmol/L, which was lower than that of the sevoflurane group (P<0.05). And the SOD level was (98.75±9.78) nU/mL, which was higher than the sevoflurane group (P<0.05). Compared with before anesthesia, the levels of insulin and cortisol increased at the end of surgery and 24 h after surgery (P<0.05). At the end of the operation, the propofol group insulin (22.69±2.28) mIU/mL was higher than the sevoflurane group, and the propofol group cortisol were (171.59±17.12) ng/mL, which were lower than sevoflurane group (allP<0.05).Conclusion:The patients undergoing radicalresection of colorectal cancer received propofol intravenous anesthesia preoperativel, which can effectively alleviate oxidative stress, and has little effect on hemodynamic parameters and stress response.