七氟醚-咪达唑仑复合诱导麻醉对直肠癌根治术患者血流动力学及CXCL8水平的影响

The Influence of Sevoflurane-Midazolam Compound Induction Anesthesia on the Hemodynamics and CXCL8 Level of the Patients Undergoing Radical Surgery for Rectal Cancer

目的:探究七氟醚-咪达唑仑复合诱导麻醉对直肠癌根治术患者血流动力学及CXCL8水平的影响。方法:将96例直肠癌根治术患者随机分为甲组和乙组,每组48例。甲组患者采用七氟醚-咪达唑仑复合诱导麻醉,乙组患者采用丙泊酚麻醉,麻醉后观察不同阶段患者血流动力学水平变化、术后不良反应发生情况、术后苏醒时间、术后首次排气时间、住院时间及术后2 h、24 h、48 h血清CXCL8水平变化。结果:麻醉前(T_(0))2组患者平均动脉压(MAP)、心率(HR)比较差异无统计学意义(P>0.05)。建立气腹后1 h(T_(1))、建立气腹后2 h(T_(2))、关闭气腹后10 min(T_(3))、拔管时(T_(4))甲组患者MAP、HR均优于乙组(P<0.05)。甲组患者不良反应发生率略低于乙组,但2组比较差异无统计学意义(P>0.05)。甲组患者术后苏醒时间、术后首次排气时间、住院时间均短于乙组(P<0.05)。甲组患者术后2 h、24 h、48 h血清CXCL8水平均低于乙组(P<0.05)。结论:七氟醚-咪达唑仑复合诱导麻醉对直肠癌根治术患者血流动力学影响较小,且术后恢复快,可明显降低患者术后炎症水平,预后良好。

Objective To explore the influence of sevoflurane-midazolam compound induction anesthesia on the hemodynamics and CXCL8 level of the patient undergoing radical surgery for rectal cancer.Methods Randomly divided 96 patients with rectal cancer and to be subject to radical surgery in author’s hospital into group A(48 cases,adopted above anesthesia)and group B(48 cases,instead of propofol for anesthesia);after anesthesia observed both groups’hemodynamics level change at different stages,postoperative unward reaction incidence status,postoperative emergence time,postoperative first flatus,and hospitalization time,as well as serum CXCL8 levels at 2,24,and 48(h)after surgery.Results At T_(0)(before anesthesia)in MAP,and HR there was no statistical difference between the two groups(P>0.05);but,at T_(1)(1 h after pneumoperitoneum established),at T_(2)(2 hrs after pnenmoperitoneum),at T_(3)(10 min pneumperitoneum closed),at T_(4)(when extubation)in MAP and HR group A was all superior to group B(P<0.05);though the incidence of unward reactions in group A was slightly lower,but between the two groups there was no statistical difference(P>0.05);in the time for emergence after surgery,for first flatus after surgery,and for hospitalization group A was all shorter than group B(all,P<0.05);in serum CXCL8 levels at 2,24 and 48(hrs)after surgery group A was all lower than group B(P<0.05).Conclusion Sevoflurane-midazolam compound induction anesthesia has smaller influence on patients’hemodynamics,can significantly reduce their inflammatory levels after surgery;and after surgery patients recovered fastly,their prognosis are better.