Effects of different anesthesia on serum SIL-2R, IL-6 and TNF-?in cancer patients undergoing thoracic surgery / 中华麻醉学杂志

ABSTRACT

Objective The aim of this study was to investigate the effects of different anesthetic drugs and techniques on serum SIL-2R, IL-6 and TNF-? in cancer patients undergoing elective thoracic surgery, trying to find a reasonable anesthesia for patients with compromised immune function. Methods Eighteen ASA Ⅰ-Ⅱ cancer patients(male 12, female 6) undergoing elective thoracic surgery were studied. The age ranged from 46-47 years. 6 patients suffered from lung cancer and 12 from cancer of esophagus or cardia. The patients received no radio-or chemotherapy before surgery. They were premedicated with intramuscular pethidine 50mg and atropine 0.5mg. Esophogus and cardia cancer patients were randomly divided into two groups group Ⅱ and Ⅱ . Group Ⅲconsisted of only lung cancer patients. Group I received general anesthesia combined with continuous epidural block and postoperative epidural analgesia. An epidural catheter was inserted at T7-8 or T8.9 before general anesthesia. Anesthesia was induced with 2% thiopental sodium 5mg kg-1 and vecuronimn 0.06-0 .08mg kg-1 and maintained with 1%-2% isoflurane inhalation with epidural 2% lidocaine 6-7m1o h-1 . After operation epidural analgesia was produced with 0.125% bupivacaine 5-6ml h-1 for 72 h. In group Ⅱ the induction of general anesthesia was the same as in group Ⅰ , but anesthesia was maintained with ketamine infusion 1-2mg kg-1h-1 and epidural 2% lidocaine 6-7ml h-1. Postoperative analgesia was produced with epidural 0.1% bupivacaine + 0.0003% fentanyl 5-6m1o h-1 for 72 h. In group Ⅲ the induction and maintenance of anesthesia were the same as in group Ⅱ but postoperative analgesia was produced with epidural 0.1 % ketamine 4-5ml h-1. Blood samples were taken from peripheral vein before anesthesia, before and 2 h after skin incision and on the 1st, 3rd and 5th day after operation for determination of serum SIL-2R, IL-6 and TNF-? by ELISA(Genozyme Co) Results The serum SIL-2R, IL-6 and TNF-? levels were comparable before anesthesia and operation among the three groups. Serum SIL-2R decreased significantly at 2 h after skin incision(P