Effect of different anesthetic methods on cellular immune functioning and the prognosis of patients with ovarian cancer undergoing oophorectomy.

The present study aimed to explore the effects of different anesthetic methods on cellular immune function and prognosis of patients with ovarian cancer (OC) undergoing oophorectomy. A total of 167 patients who received general anesthesia (GA) treatment (GA group) and 154 patients who received combined general/epidural anesthesia (GEA) treatment (GEA group) were collected retrospectively. Each group selected 124 patients that met the inclusion and exclusion criteria for further study. ELISA and radioimmunoassay were employed to detect levels of IL-2, TNF-α, and CA-125. The rates of tumor-red cell rosette (RTRR), red cell immune complex rosette (RRICR), and red cell C3b receptor rosette (RRCR) were also measured. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were determined by hemodynamics. The levels of tumor necrosis factor-α (TNF-α) and interleukin (IL)-2 decreased at 1 h intraoperation (T2), but increased 24-h post surgery (T3). The levels of TNF-α and IL-2 were recovered faster in the GEA group than in the GA group. The GA group exhibited greater levels of CA-125 expression than in the GEA group. The levels of RTRR, RRICR, and RRCR; ratios of CD3+, CD4+, CD4+/CD8+, CD16+, and CD56+ at 30 min after anesthesia (T1), T2, T3 and 48 h after the operation (T4) and levels of SBP, DBP, and HR at T1, T2, and T3 displayed increased levels in the GEA group than in the GA group. At 72-h post surgery (T5), the 5-year survival rate significantly increased in the GEA group compared with the GA group. GEA to be more suitable than GA for surgery on OC patients.

Preheating of streamlined liner of pharyngeal airway (SLIPA) reduced the related complications: a randomized control study.

This study was designed to verify whether preheating could decrease the complications that may be associated with the use of streamlined liner of pharyngeal airway (SLIPA). We evaluated the incidence of sore throat, maximum sealing pressure, hoarseness and blood stains after preheating of SLIPA. Eighty patients scheduled for hysteroscopic surgery to whom the SLIPA was considered suitable were randomly allocated to preheating group or control group. The SLIPA in preheating group was placed in the incubator at 42 °C. The control group temperature was 24 °C. The mean maximum sealing pressure and duration of insertion were compared. Patients were interviewed at recovery room about sore throat and other complications. There were statistical differences in incidence of sore throat, severity of sore throat and blood stains between groups. However there was no statistical difference in the maximum sealing pressure. Our results suggest preheating of the SLIPA decreased the complications related with the insertion of SLIPA. Clinical Trials.gov Identifier NCT02539485.

The effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study.

Postoperative respiratory complications related to endotracheal intubation usually present as cough, sore throat, hoarseness. The aim of the study was to examine the effects of endotracheal tube cuff pressure changes during gynecological laparoscopic surgery on postoperative sore throat rates. Thirty patients who underwent gynecological laparoscopic surgery and 30 patients who underwent laparotomy under general anesthesia with endotracheal intubation were included. After induction of general anesthesia and endotracheal intubation, the cuff was inflated to 25 mmHg. At 5, 15, 30, 45 and 60 min after endotracheal intubation, cuff pressure and peak airway pressure were recorded. At 2 and 24 h after surgery, the patients were assessed for complaints of a sore throat. In patients who underwent laparotomy, cuff pressure and peak airway pressure did not change significantly at different time points after intubation. In patients who received laparoscopic surgery, cuff pressure and peak airway pressure were significantly increased compared to initial pressure at all examined time points. In both groups, the endotracheal tube cuff pressure and peak airway pressure were significantly correlated (R=0.9431, P<0.01; R=0.8468, P<0.01). Compared to patients who had undergone laparotomy, patients who had undergone laparoscopic surgery showed significantly higher sore throat scores at both 2 and 24 h after surgery (P<0.01). Pneumoperitoneum and Trendelenburg position may increase airway pressure and cuff pressure, resulting in increased incidence of postoperative sore throat.

Pulmonary effects of bupivacaine and ropivacaine in parturients undergoing spinal anesthesia for elective cesarean delivery.

UNLABELLED: To study the change of maternal pulmonary function when ropivacaine and bupivacaine were used in spinal anesthesia for cesarean section, 40 ASA physical status I and II parturient scheduled to undergo cesarean section were randomly divided into bupivacaine and ropivacaine groups. Bupivacaine 9 mg and ropivacaine 14 mg were intrathecal injected respectively. FVC, FEV1 and PEFR were measured with spirometry before anesthesia and 2 h after intrathecal injection. Anesthesia level, the degree of motor block and VAS were also recorded. RESULTS: The final level of sensory blockade was not different between groups. Forced vital capacity was significantly decreased with bupivacaine (3.0 ± 0.4 L to 2.7 ± 0.3 L, P < 0.05) and ropivacaine (2.9 ± 0.4 L to 2.5 ± 0.4 L, P < 0.05) while there were no difference between two groups. Forced expiratory volume during the first second and Peak expiratory flow rate were not decreased in each group. The degree of motor block in group R was less than group B at 2 h after intrathecal injection. CONCLUSIONS: Decreases in maternal pulmonary function tests were similar following spinal anaesthesia with bupivacaine or ropivacaine for cesarean section. The clinical maternal effects of these alterations appeared negligible.

Effect of preloading epidural space with normal saline on the incidence of complications of epidural catheter placement and spinal anesthesia for cesarean section.

To evaluate the effect of preloading the epidural space with normal saline (NS) on the incidence of complications of epidural catheter placement and spinal anesthesia for cesarean section. Two hundred and ninety parturients at full term, who were scheduled for cesarean section under combined spinal-epidural anesthesia were randomly divided into two groups: group control (I) and group NS (II). The epidural puncture was performed at the estimated L3-4 interspace with a Tuohy needle attached to a 5 ml syringe. Loss of resistance to air was used to identify the epidural space. In group I no fluid was injected into the epidural space before insertion of the catheter; while in group II NS 5 ml was injected into the epidural space before catheter insertion. The incidence of blood vessel trauma and paraesthesia were evaluated. The effect of spinal anesthesia was evaluated. Blood vessel trauma in group II was significantly lower than in group I, P < 0.05. However, the incidence of paraesthesia was similar between the two groups, P > 0.05. Preloading the epidural space with NS can decrease the incidence of clinically apparent injury to blood vessels during epidural catheter placement, and can improve the effects of spinal analgesia, but does not reduce the incidence of paraesthesia.

Effects of different inhaled oxygen concentration and end-expiratory positive pressure on Pa-etCO2 in patients undergoing gynecological laparoscopic surgery.

UNLABELLED: There is some disagreement about whether the PetCO2 is reliable in predicting the PaCO2 in laparoscopic procedures with CO2 inflation. The aim of the present study is to measure the Pa-etCO2 differences over time in healthy patients undergoing gynecological laparoscopic surgery with different ventilation methods. METHODS: After intubation, patients were randomized into three groups. The patients in group A were ventilated with air/O2 (FiO2 = 50%) and supplied with PEEP (5cmH2O). The patients in group B were ventilated with 50% oxygen while the patients in group C were ventilated with 100% oxygen. All patients were conducted with volume-controlled ventilation. PetCO2 and PaCO2 were measured at baseline, one minute after intubation, every 30 min thereafter and 5 minutes after deflation of pneumoperitoneum. RESULTS: The differences in Pa-etCO2 between groups A, B and C were insignificant one minute after intubation. The Pa-etCO2 in group B and C significantly increased compared with that in group A at other time points after intubation. CONCLUSION: Oxygen concentration and positive end-expiratory pressure could affect Pa-etCO2 in laparoscopic surgery patients.