BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sev...BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sevoflurane is a volatile anesthetic that has been shown to have anti-inflammatory and antioxidant properties and attenuate lung injury in animal models.AIM To evaluate the protective effect of sevoflurane on the lung function of elderly COPD patients undergoing total hip arthroplasty(THA).METHODS In this randomized controlled trial,we randomly assigned 120 elderly patients with COPD,who were scheduled for THA,to receive either sevoflurane(sevoflurane group)or propofol(propofol group)as the maintenance anesthetic.The primary outcome was the incidence of PPCs within seven days after surgery.The secondary outcomes were changes in the lung function parameters,inflammatory markers,oxidative stress markers,and postoperative pain scores.RESULTS The results showed that the incidence of PPCs was significantly lower in the sevoflurane group than in the propofol group(10%vs 25%,P=0.02).Furthermore,the decline in the forced expiratory volume in 1 s,forced vital capacity,and peak expiratory flow was significantly lesser in the sevoflurane group than in the propofol group at 24 h and 48 h after surgery(P<0.05).The interleukin-6,tumor necrosis factor-alpha,malondialdehyde,and 8-hydroxy-2α-deoxyguanosine levels were significantly lower in the sevoflurane group than in the propofol group at 24 h after surgery(P<0.05).The sevoflurane group showed significantly lower postoperative pain scores than the propofol group at 6 h,12 h,and 24 h after surgery(P<0.05).CONCLUSION Sevoflurane protects the lung function of elderly COPD patients undergoing THA under general anesthesia by reducing the incidence of PPCs,attenuating inflammatory and oxidative stress responses,and alleviating postoperative pain.展开更多
Objective: To investigate the effect of different anesthesia methods on immune function, oxidative stress and related cytokines in elderly patients undergoing radical mastectomy. Methods: The 90 elderly patients who u...Objective: To investigate the effect of different anesthesia methods on immune function, oxidative stress and related cytokines in elderly patients undergoing radical mastectomy. Methods: The 90 elderly patients who underwent radical surgery for lung cancer from March 2016 to March 2018 were randomly divided into two groups, 45 cases each. One group was given sevoflurane inhalation anesthesia (sevoflurane group), and the other group was given propofol anesthesia (propofol group). The immune function, oxidative stress and related cytokine levels in immediately before induction of anesthesia (T0), 1 hour of surgery (T1), 2 hours of surgery(T2) and 2 hours after surgery (T3) were compared between the two groups. Result: At T1, T2 and T3, the levels of CD3+, CD4+ and CD4+/CD8+ in the two groups were significantly lower, and the levels of CD8+ were significantly higher those in T0 (P<0.05), and the levels of CD3+, CD4+ and CD4+/CD8+ in the sevoflurane group were significantly lower ,the level of CD8+ was significantly higher than those in the propofol group (P<0.05). There was no significant difference in VEGF and COX-2 levels between propofol groups at each time point (P>0.05), but at T3, VEGF and COX-2 levels in sevoflurane group were (415.12±60.23) pg/mL and (23.14±2.19) ng/mL respectively, which were significantly lower than those in T0 (P<0.05), and significantly lower than propofol group (P<0.05). There was no significant difference in MMP-2 and MMP-9 levels between propofol groups at each time point (P>0.05). The levels of MMP-2 and MMP-9 in the sevoflurane group at T2 and T3 were (324.83±26.81) ng/L, (352.05±31.96) ng/L, (313.19±27.32) ng/L and (345.21±33.04) ng/L respectively, which were significantly lower than those in T0, and significantly lower than propofol group (P<0.05). At T1 and T2, the MDA levels of the two groups were significantly higher than those in T0, and the SOD were significantly lower than those in T0 (P<0.05). At T2, the MDA level in the sevoflurane group was significantly lower than that in the propofol group (P<0.05), and the SOD level was significantly higher than that in the propofol group (P<0.05). Conclusion:Propofol intravenous anesthesia can protect the immune function of elderly patients undergoing radical lung cancer surgery, but sevoflurane can weaken the oxidative stress response and inhibit the expression of VEGF, COX-2, MMP-2 and MMP-9.展开更多
基金This study was registered in February 2018.Registration identification number is ChiCTR1900021234.
文摘BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sevoflurane is a volatile anesthetic that has been shown to have anti-inflammatory and antioxidant properties and attenuate lung injury in animal models.AIM To evaluate the protective effect of sevoflurane on the lung function of elderly COPD patients undergoing total hip arthroplasty(THA).METHODS In this randomized controlled trial,we randomly assigned 120 elderly patients with COPD,who were scheduled for THA,to receive either sevoflurane(sevoflurane group)or propofol(propofol group)as the maintenance anesthetic.The primary outcome was the incidence of PPCs within seven days after surgery.The secondary outcomes were changes in the lung function parameters,inflammatory markers,oxidative stress markers,and postoperative pain scores.RESULTS The results showed that the incidence of PPCs was significantly lower in the sevoflurane group than in the propofol group(10%vs 25%,P=0.02).Furthermore,the decline in the forced expiratory volume in 1 s,forced vital capacity,and peak expiratory flow was significantly lesser in the sevoflurane group than in the propofol group at 24 h and 48 h after surgery(P<0.05).The interleukin-6,tumor necrosis factor-alpha,malondialdehyde,and 8-hydroxy-2α-deoxyguanosine levels were significantly lower in the sevoflurane group than in the propofol group at 24 h after surgery(P<0.05).The sevoflurane group showed significantly lower postoperative pain scores than the propofol group at 6 h,12 h,and 24 h after surgery(P<0.05).CONCLUSION Sevoflurane protects the lung function of elderly COPD patients undergoing THA under general anesthesia by reducing the incidence of PPCs,attenuating inflammatory and oxidative stress responses,and alleviating postoperative pain.
文摘Objective: To investigate the effect of different anesthesia methods on immune function, oxidative stress and related cytokines in elderly patients undergoing radical mastectomy. Methods: The 90 elderly patients who underwent radical surgery for lung cancer from March 2016 to March 2018 were randomly divided into two groups, 45 cases each. One group was given sevoflurane inhalation anesthesia (sevoflurane group), and the other group was given propofol anesthesia (propofol group). The immune function, oxidative stress and related cytokine levels in immediately before induction of anesthesia (T0), 1 hour of surgery (T1), 2 hours of surgery(T2) and 2 hours after surgery (T3) were compared between the two groups. Result: At T1, T2 and T3, the levels of CD3+, CD4+ and CD4+/CD8+ in the two groups were significantly lower, and the levels of CD8+ were significantly higher those in T0 (P<0.05), and the levels of CD3+, CD4+ and CD4+/CD8+ in the sevoflurane group were significantly lower ,the level of CD8+ was significantly higher than those in the propofol group (P<0.05). There was no significant difference in VEGF and COX-2 levels between propofol groups at each time point (P>0.05), but at T3, VEGF and COX-2 levels in sevoflurane group were (415.12±60.23) pg/mL and (23.14±2.19) ng/mL respectively, which were significantly lower than those in T0 (P<0.05), and significantly lower than propofol group (P<0.05). There was no significant difference in MMP-2 and MMP-9 levels between propofol groups at each time point (P>0.05). The levels of MMP-2 and MMP-9 in the sevoflurane group at T2 and T3 were (324.83±26.81) ng/L, (352.05±31.96) ng/L, (313.19±27.32) ng/L and (345.21±33.04) ng/L respectively, which were significantly lower than those in T0, and significantly lower than propofol group (P<0.05). At T1 and T2, the MDA levels of the two groups were significantly higher than those in T0, and the SOD were significantly lower than those in T0 (P<0.05). At T2, the MDA level in the sevoflurane group was significantly lower than that in the propofol group (P<0.05), and the SOD level was significantly higher than that in the propofol group (P<0.05). Conclusion:Propofol intravenous anesthesia can protect the immune function of elderly patients undergoing radical lung cancer surgery, but sevoflurane can weaken the oxidative stress response and inhibit the expression of VEGF, COX-2, MMP-2 and MMP-9.
