Effects of different anesthesia methods on cognitive function and inflammatory factors in elderly patients with lung cancer during perioperative period / 中国基层医药

ABSTRACT

Objective To explore the effects of different anesthesia methods on cognitive function and serum interleukin-6 ( IL -6), interleukin -8 ( IL -8) levels in elderly patients with lung cancer during perioperative period.Methods From March 2015 to March 2017, ninety elderly patients undergoing radical resection of lung cancer treated in Heji Hospital Affiliated to Changzhi Medical College were selected in the research.According to the different anesthesia methods,they were divided into inhalation anesthesia group( A group),general intravenous anes-thesia group(B group) and epidural block anesthesia group(C group),with 30 cases in each group.The minimum mental state examination(MMSE) scores,cognitive dysfunction rate,serum IL-6 and IL-8 levels of the three groups before operation,one day after operation and three days after operation were compared.Results One day and three days after operation,the MMSE scores of C group were (25.62 ± 2.11) points,(27.12 ± 2.04) points,respectively, which were higher than those of group A[(22.61 ± 2.75) points,(25.78 ± 2.68)points] and B group[(22.34 ± 2.01)points,(25.81 ± 2.42) points],the differences were statistically significant(tA group =4.756,2.179,tB group =6.165,2.267,all P<0.05).One day and three days after operation,the cognitive dysfunction rates of C group were 26.67% (8/30),6.67% (2/30),respectively,which were lower than those of A group[50.00% (15/30),26.67% (8/30)] and B group[66.67% (20/30),30.00% (9/30)],the differences were statistically significant(χ2A group =3.455,4.320,χ2B group =9.643,5.455,all P<0.05).One day and three days after operation,the serum IL-6 and IL-8 levels of C group[IL-6(99.53 ± 16.82)ng/mL,(83.24 ± 8.34) ng/mL,IL-8(50.43 ± 7.84)ng/mL, (42.15 ± 5.25)ng/mL] were lower than those of A group[IL-6(122.43 ± 18.41)ng/mL,(88.51 ± 10.42)ng/mL, IL-8(64.53 ± 8.94)ng/mL,(55.62 ± 6.78) ng/mL] and B group[IL-6(124.52 ± 20.10) ng/mL,(87.95 ± 9.34)ng/mL,IL-8(63.27 ± 9.03)ng/mL,(54.62 ± 6.30) ng/mL],the differences were statistically significant (IL-6tA group =5.030,2.163,tB group =5.222,2.060,all P<0.05;IL-8tA group =6.495,8.604,tB group =5.881, 8.329,all P<0.05).Conclusion The influence of epidural block anesthesia on postoperative cognitive dysfunction in elderly patients with radical resection of lung cancer is minimal,which can inhibit the expression of inflammatory factors.It is better than the other two anesthesia methods,and it is worthy of radical operation for elderly patients with lung cancer.