Application of sevoflurane inhalation combined with epidural anesthesia in patients with colorectal cancer and its effect on postoperative perceptual function

Zhang,Xiaomin; Jiang,Hao

doi:10.3892/ol.2019.10074

Application of sevoflurane inhalation combined with epidural anesthesia in patients with colorectal cancer and its effect on postoperative perceptual function

Authors:
- Xiaomin Zhang
- Hao Jiang
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Affiliations: Department of Anesthesia, The Second Cancer Hospital of Heilongjiang Province, Harbin, Heilongjiang 150086, P.R. China, Department of Anesthesia, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China
Published online on: February 26, 2019 https://doi.org/10.3892/ol.2019.10074
Pages: 4443-4448
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Effect of sevoflurane inhalation combined with epidural anesthesia on postoperative perceptual function in patients with colorectal cancer (CRC) was investigated. The clinical data of 78 patients undergoing laparoscopic CRC radical surgery in The Second Cancer Hospital of Heilongjiang Province from June 2016 to June 2017 were retrospectively analyzed and divided into 2 groups: Sevoflurane inhalation combined with epidural anesthesia (observation group, n=40); propofol intravenous general anesthesia (control group, n=38). The mean arterial pressure and heart rate before anesthesia (T0), immediate intubation (T1), 30 min after surgery started (T2), end of surgery (T3), 10 min after extubation (T4) were compared between the two groups. The recovery conditions were also compared between the two groups. The cognitive functions were evaluated by mini-mental state scale (MMSE). The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group at T2, T3 and T4 (P<0.05). The recovery time, extubation time, anal exhaust time, eating time, urinary catheter removal time and hospital stay in the observation group were significantly lower than those in the control group (P<0.05). There was a significant difference in cognitive function between the two groups at different time points (P<0.001). Postoperative cognitive function showed a trend of decreasing first and then increasing; the scores of cognitive function in both groups 1 day after surgery were at trough level, and recovered gradually from 3 days after surgery. The mean arterial pressure and heart rate during the perioperative period are more stable in the elderly patients with sevoflurane inhalation combined with epidural anesthesia; the recovery time is shorter and more rapid, and the recovery time of postoperative cognitive function is also faster. Therefore, it provides a reference for patients undergoing CRC radical surgery to select high-quality and appropriate anesthetic protocols.

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1	Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A and Bray F: Global patterns and trends in colorectal cancer incidence and mortality. Gut. 66:683–691. 2017. View Article : Google Scholar : PubMed/NCBI
2	Huang C, Shen JC, Zhang J, Jiang T, Wu WD, Cao J, Huang KJ and Qiu ZJ: Clinical comparison of laparoscopy vs open surgery in a radical operation for rectal cancer: A retrospective case-control study. World J Gastroenterol. 21:13532–13541. 2015. View Article : Google Scholar : PubMed/NCBI
3	Ihnát P, Martínek L, Mitták M, Vávra P, Ihnát Rudinská L and Zonča P: Quality of life after laparoscopic and open resection of colorectal cancer. Dig Surg. 31:161–168. 2014. View Article : Google Scholar : PubMed/NCBI
4	Kotekar N, Kuruvilla CS and Murthy V: Post-operative cognitive dysfunction in the elderly: A prospective clinical study. Indian J Anaesth. 58:263–268. 2014. View Article : Google Scholar : PubMed/NCBI
5	Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, Sage D, Futter M, Saville G, Clark T, et al: Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: Results from overview of randomised trials. BMJ. 321:14932000. View Article : Google Scholar : PubMed/NCBI
6	Hofer CK, Zollinger A, Büchi S, Klaghofer R, Serafino D, Bühlmann S, Buddeberg C, Pasch T and Spahn DR: Patient well-being after general anaesthesia: A prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia. Br J Anaesth. 91:631–637. 2003. View Article : Google Scholar : PubMed/NCBI
7	Joo HS and Perks WJ: Sevoflurane versus propofol for anesthetic induction: A meta-analysis. Anesth Analg. 91:213–219. 2000. View Article : Google Scholar : PubMed/NCBI
8	Godet G, Watremez C, El Kettani C, Soriano C and Coriat P: A comparison of sevoflurane, target-controlled infusion propofol, and propofol/isoflurane anesthesia in patients undergoing carotid surgery: A quality of anesthesia and recovery profile. Anesth Analg. 93:560–565. 2001. View Article : Google Scholar : PubMed/NCBI
9	Jellish WS, Lien CA, Fontenot HJ and Hall R: The comparative effects of sevoflurane versus propofol in the induction and maintenance of anesthesia in adult patients. Anesth Analg. 82:479–485. 1996. View Article : Google Scholar : PubMed/NCBI
10	Lokhat D, Golandaj A and Ramjugernath D: Scale-up of sevoflurane synthesis: Selection of chemical route and influence of reagent characteristics. Int J Appl Chem. 12:455–461. 2016.
11	Schoen J, Husemann L, Tiemeyer C, Lueloh A, Sedemund-Adib B, Berger KU, Hueppe M and Heringlake M: Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: A randomized controlled trial. Br J Anaesth. 106:840–850. 2011. View Article : Google Scholar : PubMed/NCBI
12	Goswami U, Babbar S and Tiwari S: Comparative evaluation of the effects of propofol and sevoflurane on cognitive function and memory in patients undergoing laparoscopic cholecystectomy: A randomised prospective study. Indian J Anaesth. 59:150–155. 2015. View Article : Google Scholar : PubMed/NCBI
13	Gupta A, Björnsson A, Fredriksson M, Hallböök O and Eintrei C: Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic cancer surgery: A retrospective analysis of data from 655 patients in central Sweden. Br J Anaesth. 107:164–170. 2011. View Article : Google Scholar : PubMed/NCBI
14	Kehlet H: Manipulation of the metabolic response in clinical practice. World J Surg. 24:690–695. 2000. View Article : Google Scholar : PubMed/NCBI
15	Snyder GL and Greenberg S: Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth. 105:106–115. 2010. View Article : Google Scholar : PubMed/NCBI
16	Ahlers O, Nachtigall I, Lenze J, Goldmann A, Schulte E, Höhne C, Fritz G and Keh D: Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery. Br J Anaesth. 101:781–787. 2008. View Article : Google Scholar : PubMed/NCBI
17	King MS: Preoperative evaluation of the elderly. J Am Board Fam Pract. 4:251–258. 1991.PubMed/NCBI
18	Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, Stein KD, Alteri R and Jemal A: Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 66:271–289. 2016. View Article : Google Scholar : PubMed/NCBI
19	Bhattacharjee DP, Saha S and Paul S, Roychowdhary S, Mondal S and Paul S: A comparative study of esmolol and dexmedetomidine on hemodynamic responses to carbon dioxide pneumoperitoneum during laparoscopic surgery. Anesth Essays Res. 10:580–584. 2016. View Article : Google Scholar : PubMed/NCBI
20	Mutetwa EN, Shumbairerwa S, Crawford A, Madzimbamuto FD, Chimoga T and Marange-Chikuni D: Metabolic effects of Carbon Dioxide (CO₂) insufflation during laparoscopic surgery: Changes in pH, arterial partial Pressure of Carbon Dioxide (PaCo₂) and End Tidal Carbon Dioxide (EtCO₂). Cent Afr J Med. 61:61–65. 2015.PubMed/NCBI
21	Weingarten TN, Bergan TS, Narr BJ, Schroeder DR and Sprung J: Effects of changes in intraoperative management on recovery from anesthesia: A review of practice improvement initiative. BMC Anesthesiol. 15:542015. View Article : Google Scholar : PubMed/NCBI
22	Thiele RH, Rea KM, Turrentine FE, Friel CM, Hassinger TE, McMurry TL, Goudreau BJ, Umapathi BA, Kron IL, Sawyer RG, et al: Standardization of care: Impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery. J Am Coll Surg. 220:430–443. 2015. View Article : Google Scholar : PubMed/NCBI
23	Rudolph JL, Marcantonio ER, Culley DJ, Silverstein JH, Rasmussen LS, Crosby GJ and Inouye SK: Delirium is associated with early postoperative cognitive dysfunction. Anaesthesia. 63:941–947. 2008. View Article : Google Scholar : PubMed/NCBI
24	Saczynski JS, Marcantonio ER, Quach L, Fong TG, Gross A, Inouye SK and Jones RN: Cognitive trajectories after postoperative delirium. N Engl J Med. 367:30–39. 2012. View Article : Google Scholar : PubMed/NCBI
25	Li Z, Cao Y, Li L, Liang Y, Tian X, Mo N, Liu Y, Li M, Chui D and Guo X: Prophylactic angiotensin type 1 receptor antagonism confers neuroprotection in an aged rat model of postoperative cognitive dysfunction. Biochem Biophys Res Commun. 449:74–80. 2014. View Article : Google Scholar : PubMed/NCBI
26	Rundshagen I: Postoperative cognitive dysfunction. Dtsch Arztebl Int. 111:119–125. 2014.PubMed/NCBI
27	Shoair OA, Grasso Ii MP, Lahaye LA, Daniel R, Biddle CJ and Slattum PW: Incidence and risk factors for postoperative cognitive dysfunction in older adults undergoing major noncardiac surgery: A prospective study. J Anaesthesiol Clin Pharmacol. 31:30–36. 2015. View Article : Google Scholar : PubMed/NCBI
28	Strøm C, Rasmussen LS and Steinmetz J: Practical management of anaesthesia in the elderly. Drugs Aging. 33:765–777. 2016. View Article : Google Scholar : PubMed/NCBI
29	Zhang L, Chen C, Wang L, Cheng G, Wu WW and Li YH: Awakening from anesthesia using propofol or sevoflurane with epidural block in radical surgery for senile gastric cancer. Int J Clin Exp Med. 8:19412–19417. 2015.PubMed/NCBI
30	Akarsu Ayazoğlu T, Özensoy A, Geyik FD, Çalım M, Duman U and Candan MA: Effects of combined epidural analgesia with total intravenous anesthesia on risky patients underwent major abdominal surgery. Agri. 27:171–180. 2015.PubMed/NCBI
31	Nishikawa K, Nakayama M, Omote K and Namiki A: Recovery characteristics and post-operative delirium after long-duration laparoscope-assisted surgery in elderly patients: Propofol-based vs. sevoflurane-based anesthesia. Acta Anaesthesiol Scand. 48:162–168. 2004. View Article : Google Scholar : PubMed/NCBI
32	Murata F, Iwade M, Hidano G, Tsunoda C, Nagata O and Ozaki M: Recovery from propofol anesthesia is delayed in hepatectomy patients due to altered pharmacodynamics. Masui. 55:150–157. 2006.(In Japanese). PubMed/NCBI
33	Arevalo-Rodriguez I, Smailagic N, Roqué I Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, Pedraza OL, Bonfill Cosp X and Cullum S: Mini-Mental State Examination (MMSE) for the detection of Alzheimer's disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 3:CD0107832015.
34	Fu M and Li D: General anesthesia combined with epidural anesthesia on the postoperative cognitive functions in pregnant women with dystocia. Exp Ther Med. 16:1149–1152. 2018.PubMed/NCBI