Effect Of Neoadjuvant Chemotherapy In Ovarian Cancer On The Sedative Effect Of Propofol Combined With Oxycodone

Objectives:to investigate the effect of neoadjuvant chemotherapy in ovarian cancer on the sedative effect of propofol combined with oxycodone.Methods:Sixty-eight ASA I or II with ovarian cancer patients aged40⁶4 years old,scheduled for elective surgery,20kg/m²<BMI<30 kg/m²,no cardiovascular system,respiratory system and renal dysfunction;no hepatic encephalopathy,no history of mental or neurological disease,no history of drug or alcohol dependence,were divided into into 2 groups according to the chemotherapy the patients receive（n=34 each）:The neoadjuvant chemotherapy group（groupⅠ）,receivedpaclitaxel+carboplatin,andthenon-chemotherapeutic group（group II）.Before operation,three cycles of chemotherapy were performed（one chemotherapy cycle 21 days）and there are three weeks after chemotherapy in chemotherapy group.No patients received premedication.After entering the operating room,the compound sodium chloride injection was infused for 10 ml·kg^-1·h^-1.Radial artery catheterization was performed under local anesthesia,and invasive arterial pressure was monitored.Anesthesia induction:Intravenous oxycodone0.2 mg/kg,propofol was given by target-controlled infusion 4 min later,and the EC50 of propofol given by TCl was determined by up-and-down technique.The initial effect-site concentration（Ce）of propofol was 1.0μg/ml.Loss of consciousness（The OAA/S score=1）was recorded as positive and negative.If the former was positive,the target concentration of propofol was decreased in the next.If the previous case was negative,the next patient increased a concentration gradient,and the ratio between the 2 successive Ce was 1.09.The test was terminated when there were six times of crossover from negative to positive.OAA/S score,five points:normal response to normal volume call;four points:unresponsive to regular volume call;three points:no response to regular volume call,response to repeated loud call;two points:no response to repeated loud call,only respond to pat the body;one point:no response to pat the body,respond to squeezing trapezius muscle stimulation.Number of positive/negative responses were recorded in each group.The test procedure maintains a stable patient’s vital signs and anesthesia-induced intubation is performed after surgery to perform surgery.Probit method was used to calculate the half effective effective cell target concentration（EC50）and 95%confidence interval（95%CI）of target-controlled infusion of propofol when consciousness disappeared.Results:1.There was no significant difference in age,height and weight between the two groups（P>0.05）.2.The EC₅₀0 and 95%confidence interval of propofol for loss of consciousness were 1.22μg/ml（1.14-1.30μg/ml）in group I and 1.74μg/ml（1.57-3.19μg/ml）in group II.Compared with group II,the EC₅₀0 of propofol in group I was decreased when the consciousness disappeared,and the difference was statistically significant（P<0.05）.Conclusion:Neoadjuvant chemotherapy can reduce the EC50 at the disappearance of target-controlled infusion of propofol during combined oxycodone anesthesia in ovarian cancer patients,and increase the sedative effect of propofol.