ABSTRACT
Objective To investigate effects of multimodal analgesia on cytokines and cortisol levels in patients received surgical treatment for radical colon cancer.Methods Eighty-six patients with radical colon cancer treated with surgery were randomly divided into control group and observation group.The control group only received routine epidural anesthesia and the observation group received multimodal analgesia.Preoperative and postoperative VAS scores,cytokines and cortisol levels were measured.Results Compared with those of the control group,the following 5 indicators decreased significantly in the observation group including VAS scores of after 24 h,48 h,72 h,IL-8 and TNF-α after 24 h,IL-6,IL-8 and TNF-α after 48 h,Cor after 24h,and Cor and ACTH after 48 h (P＜0.05).Conclusion Perioperative multi-mode analgesia helps relieve pain,stress and inflammatory cytokines among patients after the surgery for radical colon cancer.
ABSTRACT
Objective To observe the effect of restrictive transfusion in colon cancer surgery in elderly patients on postoperative VAP (ventilator-associated pneumonia). Methods Forty cases of elderly patients with colon cancer intending to undertake surgery were randomly divided into restrictive transfusion group (group R) and standard transfusion group (group S) with 20 cases in each group. In group R, patients were administered one third of accumulative fluid loss in the first 60 minute, then the infusion rate were 4 mL/(kg·h) and central venous pressure was maintained at 5 ~ 7 cmH2O. In group S, rate of fluid administration = CVE + deficit +maintenance + loss + third space. Blood gas index including lactic acid and volumes of fluid administered, blood loss, urine volume and thoracic fluid count (TFC) were recorded in the operation. Clinical pulmonary infection score(CPIS) was recorded respectively before operation, 1 day, 3 day, 7 day after operation to evaluate the risk of VAP. Results Compare with those in group S, there were significantly less TFC and intraoperative volumes of fluid administration in group R. The CPIS was significant lower at day1, day3, day7 after operation in group R. There was no significant difference in MAP, HR, CO and urine volume between two groups. Conclusions In colon cancer surgery for elderly patients, restrictive transfusion can maintain hemodynamic stability, ensure the tissue oxygenation, reduce conjunction edema, shorten the recovery and hospital stay and reduce the incidence of VAP.