Nakanuno Ryuichi, Yasuda Toshimichi, Hamada Hiroshi, Yoshikawa Hiroshi, Nakamura Ryuji, Saeki Noboru, Kawamoto Masashi
Hiroshima J Med Sci. 2015 Sep;64(3):31-7.
Responses to surgical stress can be modulated by anesthetics. We prospectively compared the effects of two different anesthetic/sedative techniques on the peak postoperative bladder temperature (BT) and the postoperative C-reactive protein (CRP) level. Twenty patients who were scheduled to undergo elective thoracoabdominal esophagectomy were allocated to receive either propofol anesthesia followed by propofol sedation (PP group, n = 10) or sevoflurane anesthesia followed by midazolam sedation (SM group, n = 10). In each case, the patient's peak bladder temperature was measured on the morning after surgery, and their serum CRP levels were assessed on postoperative days (POD) 1, 2, and 3. The patients' postoperative clinical courses were also evaluated. The peak postoperative BT (degrees C) (37.6 ± 0.4 vs. 38.2 ± 0.6, respectively; p < 0.05) and the CRP level on POD 2 (mg/dl) (14.3 ± 3.9 vs. 20.6 ± 3.9, respectively; p < 0.05) were lower in the PP group than in the SM group. The peak postoperative BT was positively correlated with the CRP level on POD 2 (R = 0.533, p < 0.05). There were no significant differences between the clinical course-related parameters in both groups. Propofol anesthesia and postoperative propofol sedation resulted in a reduced peak postoperative BT and lower CRP levels on POD 2 after esophagectomy than sevoflurane anesthesia followed by midazolam sedation.
手术应激反应可被麻醉剂调节。我们前瞻性地比较了两种不同麻醉/镇静技术对术后膀胱温度峰值(BT)和术后C反应蛋白(CRP)水平的影响。将20例计划接受择期胸腹段食管癌切除术的患者分为两组,分别接受丙泊酚麻醉后丙泊酚镇静(PP组,n = 10)或七氟醚麻醉后咪达唑仑镇静(SM组,n = 10)。每种情况下,在术后早晨测量患者的膀胱温度峰值,并在术后第1、2和3天评估其血清CRP水平。还对患者的术后临床病程进行了评估。PP组术后BT峰值(℃)(分别为37.6±0.4和38.2±0.6;p<0.05)和术后第2天的CRP水平(mg/dl)(分别为14.3±3.9和20.6±3.9;p<0.05)低于SM组。术后BT峰值与术后第2天的CRP水平呈正相关(R = 0.533,p<0.05)。两组临床病程相关参数之间无显著差异。与七氟醚麻醉后咪达唑仑镇静相比,丙泊酚麻醉和术后丙泊酚镇静导致食管癌切除术后BT峰值降低,术后第2天CRP水平降低。