ABSTRACT
Objective To observe the effects of different anesthesia methods on immune function of patients with biliary tract surgery in patients.Methods 64 patients with ASA Ⅰ～Ⅱ grade elective biliary tract surgery were randomly divided into general anesthesia group (n= 32) and epidural anesthesia group(n = 32) respectively.The changes of T cell subsets and natural killer(NK) cells were observed.Results The levels of CD3+ 、CD4+、 CD4+、CD8+ and NK cells after anesthesia 2h,postoperation 1d and 3d were significantly lower than those before anesthesia in two groups(P<0.05) .general anesthesia group after surgery 5d were significantly lower than those before anesthesia(P<0.05) ;After surgery 1d,3d and 5d,general anesthesia group was significantly lower than epidural anesthesia group (P<0.05) ;The levels of CD3+、CD4+ in general anesthesia group was significantly lower than epidural anesthesia group(P<0.05) ,after surgery 1 d,the levels of CD4+、 CD8+ and NK cells in epidural anesthesia group were significantly lower than those in general anesthesia group(P<0.05).Conclusion Anesthesia had an inhibition of transient varying degrees for the immune function of patients uaderwent biliary tract surgery,which general anesthesia was more evident than epidural anesthesia.
ABSTRACT
BACKGROUND: The purpose of the study was to evaluate the effect of postural change on hemodynamics using thoracic eletrical bioimpedance (TEB) device during general anesthesia with enflurane-N2O-O2 and lumbar epidural anesthesia. The TEB device is safe, reliable and non-invasive way to measure hemodynmic values continuously. METHODS: General anesthesia (twenty patients) was induced by administration of pentotal sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously, and was maintained with 1 vol% of enflurane, N2O-O2 (2 l/min-2 l/min) and vecuronium 0.1 mg/kg. Epidural anesthesia (twenty patients) was performed at the level of L3-4 epidural space using 20 ml of 2% xylocaine mixed with epinephrine (5 microgram/ml). Hemodynamic changes were measured before induction, 1 and 5 minutes after intubation or epidural injection, 1, 5, 10, 20, 30 minutes after head- down tilt and 1, 5, 10 minutes after returning to the supine position. RESULTS: HR and LVSWI were minimaly affected in group E with epidural anesthesia compared to group G with general anesthesia. BP (SBP, DBP, MAP) and SVRI were remarkably increased in group G compared to group E. BP and SVRI showed rapid increse 1 minutes after head-down tilt in group G (p<0.01) and decreased gradually thereafter. SI and CI were decreased significantly in group G compared to group E (p<0.001). SI was unchanged but CI was decreasd significantly after head-down tilt in group E (p<0.05). EDI and ACI showed lower values decreased in general significantly in group G compared to group E (p<0.05). CONCLUSIONS: All hemodynamic changes were more predictable, gradual, less variable, and stable in the group with epidural anesthesia compared to the group with general anesthesia for hysterectomy.