The Influence Of General Anesthesia Surgery On Intestinal Flora In Breast Cancer Patients And Its Relationship With The Postoperative Recovery

ObjectiveIn recent years,with the development technology of modern molecular biology,we had a further understanding on the relationship between gut microbes metabolic and host organs.Adult intestinal existed a large number of microoganisms,it is mainly bacteria.Via metabolism,gut microbes produce a series of material,it not only play an important role in systemic inflammatory response and immune response,and can affect the central nervous system activity and pain response through a variety of ways.At present,the treatment for early tumor is still surgery,but postoperative recovery quality is closely related to the state of the central nervous system and the pain response.Therefore,we study by comparing the proportion and diversity of gut microbes before and post operation,to explore the effect of general anesthesia surgery on intestinal flora,and the relationship between the intestinal flora and postoperative recovery quality.MethodsParticipants included 15 patients undergoing general anesthesia breast cancer radical surgery who were treated at center of diagnosis and treatment of mammary gland disease from January 2017 to March 2017,collected patients'fecal samples pre and post operation.Anesthesia induction with fentanyl,cisatracurium,propofol,anesthesia maintain with fentanyl,remifentanil,and sevoflurane control blood pressure and heart rate changes in volatility in the basic value plus or minus 20%,and record the operation duration,anesthesia duration and dosage of fentanyl.On the first day post operation,patients give a mark with visual analog pain score(VAS)and 15 quality of recovery rating scale(QoR-15),and record the patient's postoperative hospitalization days and the postoperative adverse events.Fecal samples deal with DNA extraction,PCR amplification and sequencing to detect the diversity and proportion of microoganisms.Comparing the fecal microbes before and post operation,as well as the relationship of fecal microbes and VAS,QoR-15 scores,hospitalization days,postoperative adverse events.ResultsIn 15 patients undergoing general anesthesia breast cancer radical surgery.The patients are all women,aged from 46 to 66,ASA class?~?.The postoperative VAS score is2.80±1.08,the QoR-15 score is 107.3±14.3,postoperative hospitalization days was7.7±3.8d.2 patients had fever postoperative,and 1 patient had the infection of incision.QoR-15 scores and patients postoperative hospitalization days have linear correlation(R~2=0.549,P<0.05),while VAS and postoperative hospitalization days have no obviously correlation.The QoR-15 score have no obviously correlation with surgery duration time,anesthesia duration time,the dosage of fentanyl and VAS.There is no obvious difference between pre-operation group and post-operation group about the quantity,composition and diversity of microorganisms.The Shannon index of pre-operation group is negatively correlated with postoperative VAS score(R~2=0.316,P=0.029),and have a no obviously correlated with QoR-15 score.ConclusionsMammary gland radical surgery under general anesthesia without changing the composition and diversity of intestinal flora.There is a clear correlation between the diversity of pre-operation intestinal flora and postoperative pain.The correlation between intestinal flora and post-operation recovery quality needs further study.