Different Anesthesia In Elderly Patients With Gastric Cancer Surgery Influence Blood Concentrations Of Melatonin And Its Correlation With Postoperative Agitation

Objective：To evaluate the different anesthesia in elderly patients with gastric cancersurgery influence blood concentrations of melatonin and its correlation withpostoperative agitation.Methods：Fifty elderly patients randomly divided into2groups (n=25each).：the generalanesthesia(group T) and epidural anesthesia compound general anesthesia(group ET).ET patients choose T8-9clearance for epidural puncture, after the success of theoperation by several times with1%lidocaine+0.25%ropivacaine mixture, about10to15ml, total in15min after the epidural stop drug determination of block plane duringanesthesia induction. Two groups of patients with general anesthesia induction, in turn,given midazolam0.04mg/kg, etomidate0.2-0.3mg/kg, fentanyl3-4u g/kg, rocuronium0.6-0.8mg/kg, the interaction between for BIS value line40endotracheal intubation,after connecting the anesthesia machine for mechanical ventilation, intraoperativemaintain PetCO2for35to45mmHg, BIS values in40-50. Intraoperative propofolintravenous continuous pump2-6mg/kg·h, rui fentany6-10μg/kg·h maintain anesthesia,ET patients at intervals of about1h epidural, intraoperative on-demand static note cisatracurium0.05-0.1mg/kg, during the operation to maintain blood pressure in thefoundation of blood pressure in patients with plus or minus20%, if intraoperativeblood pressure too high or too low, given appropriate asoactie drugs (monica horizon orephedrine), if the heart rate <50times/min, the last1min did not relieve static note0.5mg atropine treatment. After the surgery, patients with spontaneous breathing recovery, SpO2remain above95%, conscious, pull out the endotracheal tube. ET patients finishepidural catheters, two groups of patients who never put off till tomorrow what you canawake after extubation were electronic analgesia pump, until2days later.The agitationscroes were evaluated and recorded,and the blood samples were taken twice: beforeinduction as well as just at the end of surgery.,then make correlation analysis. Thisexperiment to rule out the procedure in the light of melatonin secretion inhibition, allafter induction of anesthesia for the patient’s head to package processing, preoperativeall eli lidocaine cream lubrication catheter to reduce postoperative caused by catheter tostimulate the patient’s postoperative irritability.Results：The agitation scroes was significant lower in group ET than in groupT(P<0.01)；The level of postoperative blood concentrations of melatonin was higher ingroup ET than that in group T(P<0.01)；The agitation scroes and the level ofpostoperative blood concentrations of melatonin was negatively correlated.Conclusion: Elderly patients with gastric cancer in ET anesthesia method, can reducethe occurrence of postoperative agitation, and which were associated with thecirculating melatonin postoperative.