Effects Of Neoadjuvant Chemotherapy Factors On Sedative Efficacy Of Propofol In Han Patients Undergoing Radical Gastrectomy

Objective:To investigate the effect of neoadjuvant chemotherapy on sedation efficacy of propofol in patients undergoing radical gastrectomyMethods:130 patients with gastric cancer before operation in our hospital were selected,regardless of gender.ASA grade I or II,aged 40～64 years.BMI18～30kg/m2.No hearing impairment;No history of mental or neurological diseases;No long-term history of sedation drug application.No history of alcohol dependence.According to whether the patients received neoadjuvant chemotherapy before operation,they were divided into two groups:chemotherapy group（group P）and non-chemotherapy group（group NP）.Among them,there were 50 patients in group P and 80 patients in group NP.The chemotherapy group received XELOX regimen（capecitabine combined with oxaliplatin）before operation,and received chemotherapy for 4cycles,21 days per cycle,and surgery was performed about 3 weeks after chemotherapy.The patients were not treated with preoperative drugs.The initial target concentration of propofol TCI effect chamber was set to 0.6μg/ml.If the patient’s consciousness does not disappear after reaching the set target concentration for 30s,the gradient of 0.1μg/ml is used to increase step by step.The endpoint of the experiment was the disappearance of consciousness（OAA/S score=1）.At the end of the experiment,the target concentration of propofol effector chamber and BIS value were recorded.The HR and MAP were recorded before induction（T₀）and consciousness disappeared（T₁）.The preoperative hemoglobin and albumin values of the two groups were recorded.Results:1.There was no statistical difference in age,height,sex composition ratio and body mass index between the two groups（P>0.05）;Compared with NP group,the preoperative hemoglobin and albumin in group P had no significant difference（P>0.05）.2.There was no significant difference in HR,MAP and BIS values between the two groups at T₀ and T₁（P>0.05）.MAP,HR and BIS of the two groups of patients were significantly lower at T₁ than at T₀,and the difference was statistically significant（P<0.05）.3.The target plasma concentration EC₅₀ of propofol was 1.569μg/ml and 95%CI was（1.505～1.660μg/ml）when consciousness disappeared in group P patients.When consciousness disappeared in NP group,the plasma target concentration EC₅₀ of propofol was 2.085μg/ml and 95%CI was（2.023～2.168μg/ml）.Conclusions:After neoadjuvant chemotherapy in Chinese,propofol’s sedative effect is enhanced,and the EC₅₀ for consciousness disappearance is 1.569μg/ml.