Effects Of Two Anesthesia Methods On Perioperative Inflammatory Response And Postoperative Recovery Quality In Patients Undergoing Laparoscopic Radical Gastrectomy

ObjectiveTo compare the effects of propofol and sevoflurane on perioperative inflammatoryresponse and postoperative recovery quality in patients undergoing laparoscopic radical gastrectomy.MethodsEighty patients scheduled for elective laparoscopic radical resection of stomachcancer were divided into 2 groups?n=40each?according to the random number table:Propofol group?P group?and sevoflurane group?S group?.Anesthesia was maintained by continued infusion of propofol in group P,or with inhalation of sevoflurane in group S.The mean arterial pressure?MAP?and heart rate?HR?of the two groups were recored before induction of anesthesia?T₀?,90 minutes after pneumoperitoneum?T₁?,immediately after the surgery?T₂?,24 h after surgery?T₃?,48 h after surgery?T₄?.Levels of serum TNF-?,IL-6,IL-8,IL-10 and cortisol were measured at different time points.The QoR-40 was administered by an investigator blind to group allocation one day before surgery,and postoperative days 1 and 2?POD1 and POD2?.Results?1?Comparison of hemodynamic between the two groups:There was no significant difference in MAP and HR at T₀ and T₄ between the two groups.?P>0.05?.Compared with MAP and HR at the time of T₁^T₃,the sevoflurane group was higher than propofol group?P<0.05?.?2?Comparison of inflammatory response between the two groups:The levels of IL-6,IL-8,IL-10,TNF-?and cortisol of two groups of patients at T₁^T₄were significantly higher than those at T0?P<0.05?;during T1^T3,the level of IL-10 in the propofol group were significantly higher than the sevoflurane group?P<0.05?;during T₁^T₄,The levels of IL-6,TNF-?in the propofol group were significantly lower than the sevoflurane group;during T1^T3,cortisol The levels of TNF-?in the propofol group were significantly lower than the sevoflurane group;the level of IL-8in the propofol group were significantly lower than the sevoflurane group at T₂?P<0.05?.?3?Comparison of postoperative recovery quality between the two groups:The total score,emotional status score,pain score and physical comfort score of QoR-40 in propofol group were higher than those in sevoflurane group at postoperative days 1;the total score,pain score and physical comfort score of QoR-40 in propofol group were higher than those in sevoflurane group at postoperative days 2?P<0.05?.Conclusions?1?Compared with sevoflurane inhalation anesthesia,total intravenous anesthesia with propofol can be better maintain perioperative hemodynamic stability in patients undergoing laparoscopic radical gastrectomy.?1?Compared with sevoflurane inhalation anesthesia,total intravenous anesthesia with propofol can significantly reduce the perioperative inflammatory response in patients undergoing laparoscopic radical gastrectomy.?2?Compared with sevoflurane inhalation anesthesia,total intravenous anesthesia with propofol can be better to improve the quality of early postoperative recovery in patients undergoing laparoscopic radical gastrectomy.