The Infection Of Intraoperative Intravenous Anesthetics Infusion On Immune Cells In Tumor Patients

Objective: To explore the effect of intraoperative intravenous anesthetics infusionon immune cells in tumor patients under general anesthesia.Methods:30undergoing breast surgery patients who were classified as grade Iaccording to the American Society of Anesthesiologists grading system. They wererandomly allocated to receive dexmedetomidine’(group A) or saline (group B) ECG,HR, SPO2、BIS were monitored during anesthesia. In the A group, dexmedetomidinewas loaded (1μg/kg) over10min before anesthesia induction and was infused(0.4μg/kg/h) during surgery and group B received saline. In both groups, anesthesia wasinduced with1.5mg/kg propofol,0.3μg/kg sufentanil and0.2mg/kg cisatracuriumandmaintained with propofol and remifentanil.During surgery, we adjusted the doses ofpropofol and remifentanil according to the BIS and maintained it between40and60.Samples of peripheral blood were taken before the infusion of dexmedetomidine orsaline (T1), after the infusion of dexmedetomidine or saline (T2), after the induction ofanesthesia (T3), at the end of surgery (T4). Blood samples were analyzed to give thenumber of NK and the percentage of CD3、CD4、CD8respectively.Results:The maintenance doses of propofol and remifentanil were significantlylower in group A than in group B（P<0.05）. At T2,group DEX’s number of NK cellswas significantly different with group B’s20.70±6.27vs.17.03±2.85,（P<0.05）.In bothgroups,the number of NK cells at T3was less than those at T2In group A,13.05±4.68vs.20.70±6.27, P<0.05;In group B,12.73±4.19vs17.03±2.85,（P<0.05）.Ingroup A, the percentage of CD4was a increase from32.61±6.40at T1to36.82±7.85atT2（P<0.05）.In group B，the percentage CD4increase continually from35.32±6.27atT1to39.16±5.40at T2（P<0.05）, and reached46.59±8.49at T4from46.59±8.49at T3（P<0.05）. Comparison between the groups, the group A’s CD4at T4were significantly less than the group B’s37.38±6.93vs.46.59±8.49,respectively;（P<0.05）.The ratio of CD4/CD8, in group A, was different between at T11.27±0.43and atT21.43±0.46（P<0.05）. In group B, the ratio of CD4/CD8raised from1.52±0.44at T2to1.71±0.50at T3（P<0.05）. At T4, as to the comparison between the groups ofCD4/CD8, the ratio of group A was lower than group B’s.Conclusion:Induction with1.5mg/kg propofol and0.3μg/kg sufentanil couldcontribute to decrease the number of NK cells.Combined dexmedetomidine, Propofoland sufentanil didn’t attenuate suppression of the NK cells at the induction ofanesthesia.During the maintenance stage,the combination of dexmedetomidine,propofol and sufentanil might be less slightly the number of NK cells than that ofpropofol and sufentanil.