摘要
Objective:To investigate the effects of different anesthesia depth on cardiovascular response, stress level and immune function in patients undergoing radical gastrectomy for gastric cancer.Methods: Ninety-two patients who underwent radical gastrectomy in our hospital from January 2017 to June 2018 were randomly divided into group A (46 cases) and group B (46 cases). Group A received deep anesthesia (BIS:35~45) and group B received shallow anesthesia (BIS:55~65). The changes of heart rate (HR), mean arterial pressure (MAP), cortisol (Cor), adrenocorticotropic hormone (ACTH), epinephrine (E), norepinephrine (NE) and T cell subsets were compared between the two groups at different time points.Results:At T2, T3, and T4, the MAP of group B was (90.37±16.34) mmHg, (105.36±13.27) mmHg, and (86.26±15.34) mmHg, which were higher than group A, and the difference was statistically significant (P<0.05);There was no significant difference in MAP between the two groups at T1, T5 and T6 (P>0.05). There was no significant difference in HR between the two groups at each time point (P>0.05). Before anesthesia, there were no significant differences in Cor, ACTH, E, and NE between the two groups (P>0.05). At the end of surgery and 24 h after surgery, Cor, ACTH, E, and NE were higher than those before anesthesia, and the difference was statistically significant (P<0.05). At the end of surgery and 24 h after surgery, Cor, ACTH, E, and NE in group B were (164.28±40.27) ng/mL, (57.85±18.66) pg/mL, (33.36±5.83) mmol/L, (301.29±41.74) mmol/L, and (156.27±44.28) ng/mL, (50.85±11.40) pg/mL, (27.65±4.78) mmol/L, (267.22±38.21) mmol/L, both higher than group A, the difference was statistically significant (P<0.05). Before anesthesia, there was no significant difference in CD3+, CD4+, CD4+/CD8+ between the two groups (P>0.05). At the end of surgery and 24 h after surgery, the CD3+, CD4+, CD4+/CD8+ levels in the two groups were lower than those before anesthesia, and the difference was statistically significant (P<0.05). At the end of surgery and 24 h after surgery, CD3+, CD4+, CD4+/CD8+ in group B were (51.00±6.10)%, (26.85±4.31)%, (1.15±0.19), and (44.41±4.21)%, (22.41±2.51)%, (1.06±0.29), all lower than group A, the difference was statistically significant (P<0.05). There was no significant difference in CD8 level between the two groups at different time points (P>0.05).Conclusion:The effect of deep anesthesia (BIS: 35~45) on cardiovascular response, stress level and immune function in patients undergoing radical gastrectomy was milder than that of light anesthesia (BIS: 55-65).
