ISSN: 0970-938X (Print) | 0976-1683 (Electronic)
An International Journal of Medical Sciences
Objective: To investigate and compare the effect of two different anesthesia methods on expression of peripheral blood inflammatory cytokines IL-1β and IL-17 in patients with surgery for liver cancer.
Methods: 60 elderly patients with liver cancer that underwent radical resection from January 2014 to January 2016 were enrolled in this study. According to the different methods of anesthesia, patients were randomly divided into observation group (n=30) and control group (n=30). Observation group were given target controlled infusion of sufentanil combined with propofol while control group received continuous intravenous infusion of sufentanil and propofol target controlled infusion for anesthesia maintenance in surgery. The cognitive function reflected by Mini-mental State Examination (MMSE) scores. Oxidative stress was estimated through Malondialdehyde (MDA) levels and superoxide dismutase (SOD) levels, MDA levels were detected by the thiobarbituric acid method and SOD levels were detected by the xanthine oxidase method, expression levels of IL-1β, IL-17, amyloid beta proteins S100β and Aβ were compared between two groups before anesthesia, 1h after anesthesia and 1 day after operation.
Results: Cognitive function reflected by the MMSE scores in the two groups were both significantly decreased 1 hour after anesthesia (P<0.05). However, the scores of observation group were significantly higher than those of control group both 1h after anesthesia and 1 day after operation (P<0.05). There was no statistically significant difference in superoxide dismutase (SOD) activity and malondialdehyde (MDA) score before anesthesia between the two groups (P>0.05). However, MDA levels were increased and SOD activity was decreased 1h after anesthesia and 1 day after operation, and the range of change was relatively small in observation group (P<0.05). In observation group, the expression levels of IL-1β and IL-17 were significantly lower than those in control group 1h after anesthesia and 1 day after operation (P<0.05), but with no significant difference from those before anesthesia (P>0.05). While in control group there was significant difference in the expression levels of IL-1β and IL-17 between 1 h after anesthesia as well as 1d after operation and those before anesthesia (P<0.05). Compared with before anesthesia, the expression levels of amyloid beta proteins S100β and Aβ increased significantly 1h after anesthesia and 1d after operation in the two groups. However, the degree of increase in observation group was significantly lower than that in control group (P<0.05).
Conclusion: During radical resection for liver cancer, both two methods of anesthesia will affect patient’s postoperative cognitive function to a certain extent, but sufentanil combined with propofol target controlled infusion has relatively smaller effect and better inhibits stress response in patients after anesthesia, thus serving as an ideal method of anesthesia and analgesia.Author(s): Quanjun Cao, Ke Zhang, Jing Li