Comparisons of different general anesthetic techniques on immune function in patients undergoing flap reconstruction for oral cancer.
Medicine (Baltimore)
; 103(27): e38653, 2024 Jul 05.
Article
in En
| MEDLINE
| ID: mdl-38968483
ABSTRACT
BACKGROUND:
Anesthetic-induced immunosuppression is of particular interest in tumor surgery. This study aimed to investigate the influence of the 4 most common general anesthetic techniques on immune function in patients undergoing flap reconstruction for oral cancer.METHODS:
116 patients were randomly divided into 4 groups. Patients in group S were given sevoflurane-based anesthesia. Group P was administered propofol-based anesthesia. The SD group received sevoflurane combined with dexmedetomidine anesthesia. The propofol combined with dexmedetomidine anesthesia (PD) group received PD. Blood samples were obtained at 5 time points baseline (T0), 1 hour after the start of the operation (T1), end of the operation (T2), 24 hours (T3), and 48 hours (T4) after the operation. Lymphocyte subsets (including CD3+, CD4+, CD8+, and B lymphocytes) and dendritic cells were analyzed by flow cytometry. Blood glucose, norepinephrine, and cortisol levels were measured using ELISA and a blood gas analyzer respectively.RESULTS:
In total, 107 patients were included in the final analysis. Immunological indicators, except CD8+ counts, were all decreased in groups S, P, and SD at T1-4 compared with the baseline value, and the counts of CD3+, CD4+, and dendritic cells, as well as CD4+/CD8+ ratios, were significantly higher in the PD group than in the S, P, and SD at T1-3 (Pâ <â .05). There were no significant differences between groups P and SD at any observation time point. Intraoperative stress indices, including norepinephrine and cortisol levels, were significantly lower in the PD group than in the other 3 groups at T1-2 (Pâ <â .05).CONCLUSION:
These findings suggest that PD as a probably optimal choice can alleviate immunosuppression in patients undergoing flap reconstruction for oral cancer.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgical Flaps
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Mouth Neoplasms
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Propofol
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Plastic Surgery Procedures
/
Anesthesia, General
Limits:
Adult
/
Aged
/
Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Medicine (Baltimore)
Year:
2024
Document type:
Article
Country of publication:
Estados Unidos