Influence of intravenous-inhalation combined anesthesia and total intravenous anesthesia on postoperative immune function and inflammatory mediators in patients having underwent modified radical mastectomy during same anesthetic depth / 中国医师进修杂志

ABSTRACT

Objective To study the influence of intravenous-inhalation combined anesthesia and total intravenous anesthesia on postoperative immune function and inflammatory mediators in patients having underwent modified radical mastectomy during same anesthetic depth. Methods The clinical data of 106 patients having underwent modified radical mastectomy from August 2013 to December 2016 were retrospectively analyzed. In the patients, intravenous-inhalation combined anesthesia was in 56 cases (combined anesthesia group), and total intravenous anesthesia was in 50 cases (intravenous anesthesia group). The peripheral blood cellular immune indexes CD4+, CD8+ and CD4+/CD8+; serum humoral immunity indexes IgA, IgG and IgM; serum inflammatory mediators interleukin (IL)-6, IL-10, tumor necrosis factor(TNF)-α and C-reactive protein(CRP)2 h after operation were compared between 2 groups.Results The CD4+and CD4+/CD8+levels 2 h after operation in combined anesthesia group were significantly higher than those in intravenous anesthesia group (0.31 ± 0.04 vs. 0.29 ± 0.03 and 1.28 ± 0.15 vs.1.17 ± 0.13),the CD8+was significantly lower than that in intravenous anesthesia group (0.34 ± 0.04 vs. 0.36 ± 0.04), and there were statistical differences (P<0.01 or <0.05). The IgA, IgG and IgM levels 2 h after operation in combined anesthesia group were significantly higher than those in intravenous anesthesia group(1.18 ± 0.15)g/L vs.(0.97 ± 0.11)g/L,(7.96 ± 0.88)g/L vs.(7.18 ± 0.85)g/L and (0.82 ± 0.09) g/L vs. (0.72 ± 0.08) g/L, and there were statistical differences (P<0.05). The IL-6, IL-10,TNF-α and CRP levels 2 h after operation in combined anesthesia group were significantly lower than those in intravenous anesthesia group(39.68 ± 4.52)ng/L vs.(50.37 ± 6.18)ng/L,(7.05 ± 0.88)ng/L vs. (11.19 ± 2.41) ng/L, (62.38 ± 7.19) ng/L vs. (78.54 ± 9.17) ng/L and (22.53 ± 3.18) mg/L vs. (39.47 ± 4.51)mg/L,and there were statistical differences(P<0.01).Conclusions Compared with total intravenous anesthesia, the intravenous-inhalation combined anesthesia at the same anesthesia depth is helpful to reduce the postoperative immune suppression and systemic inflammatory response in patients undergoing modified radical mastectomy.