Effect Of Esmolol On Serum Inflammatory Cytokines In Patients Undergoing Thoracoscopy Lobectomy

Objective:To observe the effect of intraoperative continuous infusion of esmolol on the serum inflammatory cytokines in patients undergoing thoracoscopy lobectomy,and explore its lung protective effect on these patients and provide a reference for clinical application.Methods:Sixty patients diagnosed of lung cancer who underwent thoracoscopy of right upper lobectomy in our hospital,aged 40-65 years,were selected and randomly divided into group E?esmolol group?and group C?control group?,30 patients in each group.In group E,0.5mg/kg esmolol as a loading dose was infused slowly before the induction of anesthesia,and then infused at a constant rate of 50?g.kg^-1.min^-11 to the end of the operation.Group C was given the same volume of saline in the same way.The changes in MAP and HR at relevant time of before anesthesia induction?T₀?,double-lumen endobronchial intubation?T₁?,start of one lung ventilation?T₂?,30 min after initiation of OLV?T₃?,90 min after initiation of OLV?T₄?,and start of two lung ventilation?T₅?,at the end of surgery?T₆?were recorded in both groups.5ml central venous blood was collected at T₀,T₃,T₄,T₆ and 4 hours after operation?T₇?.And the concentration of serum tumor necrosis factor-??TNF-??,interleukin-8?IL-8?,Interleukin-6?IL-6?were measured by enzyme-linked immunosorbent assay?ELISA?.At the same time,the use of vasoactive drugs during operation and the incidence of pulmonary complications within 72 hours after operation were compared between the two groups.Results:1.There were no significant differences in gender,age,BMI,ASA grade,lung function,operation time,one lung ventilation time,fluid volume,blood loss and urine volume between the two groups?P>0.05?.2.Compared with T₀,MAP and HR in T₁ of the two groups were increased?P<0.05?,MAP and HR in T₂^T₆ were decreased?P<0.05?.MAP and HR at T₁ in group E were significantly lower than those in group C?P<0.05?;MAP at T₄^T₆ in group E were lower than that of group C?P<0.05?;HR at T₂^T₆ in group E were lower than that of group C?P<0.05?,but the heart rate fluctuations are more stable.3.The concentrations of serum TNF-?and IL-6 in both groups were gradually increased from T₃?P<0.05?,but there was no significant difference in the concentration of TNF-?at T₆^T₇?P>0.05?;the serum IL-8 concentration gradually increased from T₄?P<0.05?.4.Compared with group C,the concentrations of serum TNF-?and IL-6 in group E at T₃,T₄,T₆ and T₇ were lower?P<0.05?,the concentration of serum IL-8at T₄,T₆,T₇ were lower?P<0.05?.5.There were no significant differences in the use of vasoactive drugs during operation and the incidence of pulmonary complications within 72 hours after operation?P>0.05?.Conclusion:Intraoperative continuous infusion of esmolol can decrease the concentration of serum TNF-?,IL-8,IL-6 in patients undergoing thoracoscopic lobectomy,reduce the inflammatory response caused by noxious stimulation during operation,and has a certain effect on lung protection in these patients.In addition,continuous infusion of small doses of esmolol can effectively maintain the stability of the patient's hemodynamics.