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| Effects of general anesthesia combined with epidural block anesthesia during operation of elderly patients with cervical cancer on their anesthetic effect, cardiac function, and immunologic function |
| 1.The Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009; 2. Chiping District People’s Hospital of Liaocheng, Shandong Province |
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Abstract To investigate the effects of general anesthesia combined with epidural block anesthesia during operation of elderly patients with cervical cancer on their anesthetic effect, cardiac function, and peripheral blood T cell subsets. Methods: 160 elderly patients with cervical cancer confirmed by cervical biopsy pathology were selected and were randomly divided into two groups(80 cases in each group) from January 2019 to January 2023. The patients in the control group accepted general anesthesia during operation, and the patients in the observation group accepted the general anesthesia combined with epidural anesthesia. The anesthetic effect and the adverse events of the patients in the two groups were recorded. The values of the cardiac function indexes, such as systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR), cardiac output(CO), and cardiac index(CI), before operation, during operation, and at postoperative wakefulness, the values of the peripheral blood T cell subsets, such as CD3+, CD4+, CD8+, CD4+/ CD8+, and natural killer cell(NK), before operation and in postoperative 1d, 3d, and 5d, the levels of oxidative stress index, such as heme oxygenase-1(HO-1), malondialdehyde(MDA), superoxide dismutase(SOD), angiotensin II(Ang II), and norepinephrine(NE), and the levels of the inflammatory factors, such as interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), and C-reactive protein(CRP), of the patients in the two groups were recorded. Results: There were no significant differences in the postoperative recovery time and the extubation time of the patients between the two groups(P>0.05). The Ramsay sedation score of the patients in the two groups in 1 to 60 minutes after extubation had decreased significantly, but which of the patients in the observation group was significantly higher than that of the patients in the control group(P＜0.05). The values of SBP, DBP, and HR of the patients during the operation had decreased significantly, while the values of CO and CI of the patients during the operation had increased significantly. The cardiac function indexes of the patients in the two groups at postoperative wakefulness had recovered to the preoperative level to varying degrees, but the change degree of which of the patients in the observation group was significantly lower than that of the patients in the control group(all P＜0.05). The levels of CD3+, CD4+, CD4+/CD8+, NK, HO-1, and SOD in peripheral blood of the patients in both groups in 1d after surgery had decreased significantly, while the levels of MDA, AngⅡ, NE, IL-6, TNF-α, and CRP had increased significantly. The levels of CD3+, CD4+, CD4+/CD8+, NK, HO-1, and SOD in peripheral blood of the patients in both groups in 3d and 5d after surgery had increased to varying degrees, while the levels of MDA, AngⅡ, NE, IL-6, TNF-α, and CRP had decreased to varying degrees, and the change degrees of which of the patients in the observation group were significantly lower than those of the patients in the control group(all P＜0.05). Conclusion: General anesthesia combined with epidural block anesthesia during operation of the elderly patients with cervical cancer can improve their anesthesia effect, with less influences on their cardiac function and T cell subsets in the peripheral blood.
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