The influence of epidural analgesia on stress, immune and survival in patients with ovarian cancer undergoing cytoreductive surgery / 中华内分泌外科杂志

ABSTRACT

Objective To explore the influence of epidural analgesia on stress,immune and survival in patients with ovarian cancer undergoing cytoreductive surgery.Methods 72 cases with ovarian cancer undergoing cytoreductive surgery were divided into group A and group B according to random number table method.Patients in group A were treated with epidural analgesia,while patients in group B were treated with intravenous analgesia.The stress index,the plasma cortisol and immune indexes,CD3+,CD4+,CD8+ and CD4+/CD8+ at 30 mins before surgery (T1),right after surgery (T2),12 h after surgery (T3),1 d after surgery (T4) and 3 d after surgery (T5) between the two groups were observed.The overall survival and free survival in the two groups were compared.Results The plasma cortisol levels was lower in group A than in group B (Fgroup=27.784,P=0.000).The plasma cortisol levels in the two groups increased first and then decreased (Ftime=109,268,P-=0.000),and the decrease ratein group A was higher than that in group B (Finteraction,=22.092,P=0.000).The levels of CD3+,CD4+ and CD4+/CD8+ werehigher in group A than in group B,while the level of CD8+ was lower in group A than in group B (Fgroup=5.893,6.110,7.283,5.593,P＜0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in the two groups reduced first and then increased while the level of CD8+ increased first and then reduced (Ftime=12.220,14.430,15.592,11.102,P＜0.05).CD3+,CD4+ and CD4+/CD8+ in group A increased more while C D8+ reduced more than those in group B (Finteraction=8.251,9.792,8.092,7.103,P＜0.05).The overall survival rate and free survival rate of 3 years in group A and group B was 44.44％,22.22％ vs 38.89％,16.67％,respectivelyThedifferencehadnostatisticalsignificancebetweenthetwogroups (P＞0.05).Conclusion Epidural analgesia may reduce the stress response in patients with ovarian cancer undergoing cytoreductive surgery,and protect the immune function,but the influence on survival is not obvious.