Propofol for Anesthesia and Postoperative Sedation Resulted in Fewer Inflammatory Responses than Sevoflurane Anesthesia and Midazolam Sedation after Thoracoabdominal Esophagectomy

摘要

Responses to surgical stress can be modulated by anesthetics. We prospectively compared the effects of two different anesthetic/sedative techniques on the peak postoperative bladder temperature (BT) and the postoperative C-reactive protein (CRP) level. Twenty patients who were scheduled to undergo elective thoracoabdominal esophagectomy were allocated to receive either propofol anesthesia followed by propofol sedation (PP group, n = 10) or sevoflurane anesthesia followed by midazolam sedation (SM group, n = 10). In each case, the patient's peak bladder temperature was measured on the morning after surgery, and their serum CRP levels were assessed on postoperative days (POD) 1, 2, and 3. The patients' postoperative clinical courses were also evaluated. The peak postoperative BT (℃) (37.6 ± 0.4 vs. 38.2 ± 0.6, respectively; p ＜0.05) and the CRP level on POD 2 (mg/dl) (14.3 ± 3.9 vs. 20.6 ± 3.9, respectively; p ＜0.05) were lower in the PP group than in the SM group. The peak postoperative BT was positively correlated with the CRP level on POD 2 (R = 0.533, p ＜ 0.05). There were no significant differences between the clinical course-related parameters in both groups. Propofol anesthesia and postoperative propofol sedation resulted in a reduced peak postoperative BT and lower CRP levels on POD 2 after esophagectomy than sevoflurane anesthesia followed by midazolam sedation.