Volume 29, Issue 4, 2020
DOI: 10.24205/03276716.2020.897
Effects of Different Anesthesia Methods on Infection, Immune Function and Stress Response of Elderly Patients After Radical Gastrectomy
Abstract
AIM:
To evaluate the effects of general anesthesia and general anesthesia combined
with epidural anesthesia on the infection, immune function and stress response of
elderly patients after radical gastrectomy.
MATERIALS AND METHODS:
A total of 118 elderly patients undergoing radical
gastrectomy from October 2016 to November 2019 were randomly divided into control
group (n=59) and experimental group (n=59), and treated with general anesthesia and
general anesthesia combined with epidural anesthesia, respectively. The time of
recovery from anesthesia and pulmonary infection after operation were recorded. The
indices of immune functio n (NK cells, CD3+, CD4+ and CD8+ T lymphocytes) and stress
response [C reactive protein (CRP), norepinephrine (NE), epinephrine (E),
adrenocorticotropic hormone (ACTH) and cortisol (COR)] were compared.
RESULTS:
The time of recovery of spontaneous respirat ion, eye opening on calling and
extubation of experimental group was shorter than that of control group (P<0.05). The
experimental group had fewer cases of pulmonary infection, fever, cough, sputum
production and pulmonary rales than control group (P<0.05) 0.05). The number of NK cells,
counts of CD3+ and CD4+ and CD4+/CD8+ ratio decreased markedly at T2 compared
with those at T1 (P<0.05), and increased obviously at T3 in both groups (P<0.05). At T2
and T3, the above values were higher in experimental group than those in control group
(P<0.05). Compared with T1, the levels of CRP, NE, E, ACTH and COR in both groups
increased distinctly at T2 (P<0.05), but declined prominently at T3 (P<0.05). The
experimental group had lower levels of these indices at T2 and T3 (P< 0.05).
CONCLUSIONS:
During the radical gastrectomy for elderly patients, general anesthesia
combined with epidural anesthesia shortens the time of recovery from anesthesia,
reduces the risk of postoperative pulmonary infection and significantly alleviates the
suppression of immunity function and stress response, which is conducive to the
prognosis.
Keywords
Anesthesia, Radical Gastrectomy, Elderly, Infection, Immune Function, Stress Response