ORIGINAL ARTICLE   

Minerva Chirurgica 2020 December;75(6):449-56

DOI: 10.23736/S0026-4733.20.08283-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effects of different anesthesia and analgesia on cellular immunity and cognitive function of patients after surgery for esophageal cancer

Rongyu ZHU, Jun XIANG, Ming TAN ✉

Department of Anesthesiology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei, China

BACKGROUND: The study intends to analyze influences of different anesthesia and analgesia on cellular immune and cognitive functions of patients undergoing thoracotomy for esophageal cancer (EsC).
METHODS: Patients undergoing thoracotomy for EsC were divided into four groups: Group A (received general anesthesia [GA]) and postoperative intravenous analgesia); B (received GA and postoperative epidural analgesia); C (received GA combined with thoracic epidural anesthesia [TEA]) and postoperative intravenous analgesia); D (received GA combined with TEA and postoperative epidural analgesia). The T-lymphocyte subsets were determined at 30 min before anesthesia induction (T0), 2 h after skin incision (T1), and at 4 h (T2), 24 h (T3), and 48 h (T4) after operation. Besides, visual analogue scale (VAS) and mini-mental state examination (MMSE) were assessed.
RESULTS: The percentage of CD3⁺ and CD4⁺ cells in groups B and C were higher than group A from T1 to T3. The ratio of CD4⁺/CD8⁺ in group B and C were higher than in group A at T3. Compared with group A, group D had increased percentages of CD3⁺ and CD4⁺ from T1 to T4, and elevated ratio of CD4⁺/CD8⁺ from T2 to T4 VAS scores were lower and MMSE scores were higher in groups B, C, and D than in group A, and group D had relatively lower VAS and higher MMSE scores as compared to group B.
CONCLUSIONS: The intraoperative general anesthesia combined with thoracic epidural anesthesia and postoperative epidural analgesia may reduce adverse effect on cellular immune and cognitive functions of patients undergoing thoracotomy for EsC.

KEY WORDS: Anesthesia; Analgesia; Esophageal neoplasms