Effects Of Low Tidal Volume Combined With Low PEEP On IL-6 And IL-10 In Perioperative Anesthesia In Elderly Prone Patients

Objective To investigate the effects of low tidal volume combined with low Positive end-expiratory pressure on IL-6 and IL-10 during general anaesthesia for elderly patients undergoing prone position surgery.MethodsSixtypatients undergoing elective lumbosacral surgery were selected,aged from 65 to 75,ASA I to III,and body mass index 18.5 to 26 kg/m².Randomly allocated patients to eithermechanical ventilationA group with VT 8 mL/kg ideal body weight（n=30）,respectively,or B group VT6 mL/kg ideal body weight with positive end-expiratory pressure and 5cm H₂O（n=30）.Hemodynamics,airway mechanics,PaO₂、PaO₂/FiO₂ and PaCO₂,and inflammatory markers were monitored.Interleukin-6 and IL-10were determined by enzyme-linked immunosorbent assay（ELISA）technique after 0min（T₀）,30min（T₁）,60min（T₂）,120min（T₃）and 30min（T₄）after tracheal extubation in plasma after of mechanical ventilation.Results At the time of T₂,T₃,and T₄,the concentrations of plasma IL-6 and IL-10 in group B were significantly lower than group A,and the difference was statistically significant（P<0.05）.Compared with T₀,the concentrations of IL-6 at T1,T₂,T₃,and T₄ were significantly higher at each time point（P<0.05）.The concentration of IL-10 in plasma of group A was significantly higher at T₄.The difference was statistically significant（P<0.05）.In group B,the concentration of IL-10 in plasma at each time point of T₂,T₃,and T₄ was lower than before,and the difference was statistically significant（P<0.05）.PaO₂,PaO₂/FiO₂ and PaCO₂ in group B at T₂,T₃ and T₄ were significantly higher than those in group A,and the difference was statistically significant（P<0.05）.At the time of T₃,the Cydn of the two groups was significantly lower than that of the B group（P<0.05）.Compared with T₁,Cydn decreased significantly at T₃,and the difference was statistically significant（P<0.05）.At the other time points,PaO₂,PaO₂/FiO₂,PaCO₂,Ppeak,Pmean,HR,MAP,and postoperative pulmonary complications were not statistically different（P>0.05）.ConclusionsLow tidal volume（V_t 6 ml/kg）combined with 5cmH₂O PEEP ventilation method could reduce the release of IL-6 and IL-10 in the patient,improves the oxygenation state,and has no obvious effect on hemodynamics during in the prone position surgery in elderly general anesthesia.