Abstract:
This study was designed to compare the effects of TIVA (total intravenous anesthesia) by propofol and sevoflurane inhalation on perioperative inflammatory response, pulmonary function and postoperative cognitive function in patients with lung cancer resection. A total of 98 patients were randomly divided into study and control group with 49 cases in each group. The study group was given total intravenous anesthesia with propofol while the control group underwent simple inhalation anesthesia with sevoflurane. A-aDO2 (Alveolar-arterial oxygen partial pressure difference), RI (respiratory index), Qs/Qt (intrapulmonary shunt), MMP-9 (serum matrix metalloproteinase-9) and MDA (malondialdehyde) concentrations were compared between the two groups respectively at T0 (immediately before anesthesia induction), T1 (immediately at the beginning of OLV), T2 (immediately at the end of OLV), T3 (immediately before, immediately after closure of thoracic incision) and T4 (24h after operation). The MMSE score of two groups were compared before operation at 6, 24, 72 h and 7 d after operation. The A-aDO2, RI and Qs/Qt of two groups were significantly higher at T3 -T4 than at T0 and T3 the concentrations of MMP-9 and MDA were markedly increased. Compared with the control group, the concentrations of A-aDO2, MMP-9 and MDA at T3, the RI at T2-T3 and the Qs/Qt at T1-T3 all were lower in the study group. The MMSE (Mini Mental State Scale) score of the control group was higher than study group at 24 and 72 h after operation. The anesthesia with propofol can significantly reduce the perioperative inflammatory response and peroxidation with fewer damages on lung function.
