Effects of Target-controlled Infusion of Etomidate Combined with Remifentanil on Immune and Stress Re-sponse Indexes in Elderly Surgery Patients / 中国药房

ABSTRACT

OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONSThe target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.