Effect Of Different Methods Of Anesthesia And Analgesia On The Cell Immue Function On And Hormone Levels Of Breast Cancer Patients

Objective:objective to observe the change of the blood dynamics, and anesthesia effect, and related should stress hormone level of changes (rush breast pigment, and white cell between pigment-8, and growth pigment, and cortex alcohol, and adrenaline) effected before and after the surgery by controlled hard film outside analgesia and simple body anesthesia and controlled vein analgesia line breast cancer.Methods:80cases, ASA Ⅰ-Ⅱ class, no epidural anaesthesia puncture contraindications, were selected by modified radical operation for breast cancer patients. The patients were divided into two groups, each group of40patients. A group:General anesthesia combined with epidural anesthesia and patient controlled epidural analgesia for patients across; B group:Simple general anesthesia, patient-controlled intravenous analgesia for patients down. All patients, before the room, were invasion30min0.5mg intramuscular injection of atropine, respectively, entering after routine monitoring of electrocardiogram (ECG), heart rate (HR) and blood pressure (NIBP), pulse oxygen saturation (SpO2) were detected. Mask for oxygen, open venous channel infusion of ringer’s at6ml/kg/h pace. In A group, success outside cavity injected test volume5ml (1%lidocaine due to), after5minutes by hard film outside catheter injected1%lidocaine due to5-8ml, made anesthesia plane maintained in chest2to chest9, maintained volume each across1h since hard film outside catheter injected1%lidocaine due to5-7ml, or continuous hard film outside pump into5-7ml1%lidocaine. In two groups, induction of general anesthesia was used as follow:0.05-0.2mg/kg Midazolam,1.5-2.5mg/kg propofol,0.07-0.15/kg Vecuronium Bromide,0.2-0.4mg fentanyl. Tracheal intubation patients maintained propofol used in3-9mg/kg-h and0.1-0.3μg/kg-min remifentanil clinical Vecuronium continuously to maintain the muscle relaxation. Analgesic methods:In A group, retained epidural catheter connected patient-controlled analgesia epidural analgesia. Analgesic formula:fentanyl in bupivacaine0.75%(0.4mg in20ml) and droperidol5ml-100ml,2ml/h total added saline solution up to pump, control additional doses of0.5ml, locking time15min. In B group, until the operation is finished20min fentanyl intravenous0.05mg, patient-controlled intravenous analgesia. Analgesic formulations:fentanyl0.015-0.020mg/kg+saline dilution to100ml. Analgesia pump setting method, load5ml,2ml/h pump, control additional doses of1.5ml, locking time15min. The different anesthesia and postoperative analgesia on peri-anesthesia period of t-lymphocyte subsets in patients with malignant tumors, NK cells and effects of stress hormones were studied by flow cytometry.Results:1. The MAP and HR in B group were significantly higher than A group (P<0.05).2. In two groups, PRL levels in each group are lowest at TO and highest at T1. At T1, PRL levels in B groups is significantly higher than A group (P<0.05).3. In A group, GH levels at T1and T2is higher than T0, T3and T4(P<0.05). In B group, GH levels at T2and T3is higher than T0, T1and T4(P<0.05). GH levels in group A was higher than group B.4. IL-8level, in A group, was highest at TO (P<0.05). There was no significant difference in B group. A group is smaller than B group (P<0.05).5. There was no significant difference in two groups at the COR level.6. In A group, IFN-y levels at T3and T3is higher than TO (P<0.05). In B group, IFN-y levels at T3and T4is higher than TO (P<0.05). There was no significant difference in two groups.7. T1and T2in A group of CD3+is significantly lower than the other three groups (P<0.05). In B group of T1CD3+is significantly lower than the other four groups (P<0.05). In group A CD4+t-groups were not significantly different (P>0.05). In B group, CD4+was rising (P<0.05). B group was substantially higher than A group (P<0.05). There was no significant difference between two groups (P>0.05). Two groups of patients CD4+/CD8+there were no significant differences in two groups (P>0.05). In B group, CD4+/CD8+at various points in time gradually reduced (P<0.05). T2, T3, T4, in A group, was significantly higher than B group (P＜0.05).8. NK. cells in A group, was no significant difference (P>0.05). In B group, NK cells at T2, T3, T4was significantly higher than TO and T1(P<0.05). At T3and T4, A group is significantly higher than B group (P＜0.05).Conclusions:1. Before the anesthesia in breast cancer, the patients has been in a stress state General anesthesia combined with epidural anesthesia inhibited stress reaction was better than modified radical mastectomy.2.The postoperative patient-controlled epidural analgesia with patient-controlled intravenous analgesia effect, and are conducive to the early build-up in postoperative patients with complex, complications of analgesia of the former than the latter.3. The general anesthesia combined with epidural anesthesia was better stimulated the activity of t-lymphocyte subsets and NK cell numbers.