Effect of propofol and sevoflurane on perioperative and postoperative outcomes in lung cancer patients after thoracoscopic surgery

摘要

Purpose: To investigate the effects of propofol and sevoflurane on intraoperative and postoperative outcomes of lung cancer patients after thoracoscopic surgery. Methods: Lung cancer patients (n = 265) aged 51 – 73 years (mean age = 62 ± 11 years) who underwent thoracoscopic surgery under propofol or sevoflurane anesthesia were recruited over a 2-year period for this study. Data on perioperative pulmonary function, inflammatory responses, awakening time, postoperative pain and adverse reactions, pre- and postoperative cognitive functions, as well as duration of hospital stay were retrospectively analyzed. Results: Perioperative pulmonary function was poor in patients who were operated under sevoflurane, relative to those who were operated under propofol (p 0.05). After sternal closure (just before one-lung ventilation), levels of serum of interleukin 6 (IL-6), matrix metalloproteinase 9 (MMP-9), and S100β protein were reported to be higher in patients of sevoflurane group than those in propofol group, but interleukin 10 (IL-10) level was markedly reduced in sevoflurane group, relative to propofol group (p 0.05). Awakening times and visual analog scale score of patients 24 h after thoracoscopic surgery of patients in sevoflurane group were significantly higher than those in propofol group (p 0.05). Conclusion: These results indicate that propofol is more effective than sevoflurane in the protection of pulmonary and cognitive functions of patients after thoracoscopic surgery. Thus, intravenous propofol anesthesia is recommended for thoracoscopic surgery for lung cancer.