Effects Of General Anesthesia In Combination With Epidural Block On Hemorheology In Elderly Patients With Laparoscopic Radical Resection Of Colorectal Cancer

Objective:To study the effect of general anesthesia in combination with epidural block on hemorheology in elderly patients with laparoscopic radical resection of colorectal cancer.Methods:A total of 60 elderly patients with elective laparoscopic radical resection of colorectal cancer were selected,with an age range of 60-75 years,BMI of 18.5-27.5 kg/m2 and ASA ?-?.They were divided into general anesthesia group(group G,n=30)and general anesthesia in combination with epidural block group(group G+E,n=30)according to a random number table.Patients in group G only underwent the general anesthesia,while patients in group G+E underwent the combined epidural block on the basis of anesthesia in group G.The central venous pressure(CVP)and invasive arterial blood pressure were continuously monitored during the operation of the two groups of patients.The bispectral index(BIS)was connected by monitor to monitor the anesthesia depth of the patients and maintain the BIS value of 40-50.The patients in both groups were intravenously infused with compound sodium chloride injection and 6%of hydroxyethyl starch injection 130/0.4 at a rate of 10 ml·kg-1·h-1 and a ratio of 2:1 until the end of operation to maintain the CVP of 5-12 cmH2O.Before induction of general anesthesia(T0),5 min(T1)before the establishment of pneumoperitoneum,30 min(T2)after the establishmen of pneumoperitoneum and 30 min(T3)after the elimination of pneumoperitoneum were set as the monitoring time points.Determination of arterial blood gas:pH value,partial pressure of carbon dioxide(PaCO2)and bicarbonate(HCO3-).Determination of hemorheological indexes:high shear blood viscosity(H?b),low shear blood viscosity(L?b),viscosity of plasma(?p),erythrocyte aggregation index(EAI),hematocrit(Hct)and erythrocyte sedimentation rate(ESR).All data in this study were statistically analyzed by statistical software.Results:(1)Comparison of General Data:The differences in sex,age,BMI index,ASA grade,pneumoperitoneum time,operation time and intraoperative fluid infusion and urine volume were not statistically significant(P>0.05)between the two groups.(2)Arterial Blood Gas Change:?Comparison between groups The difference in T1,T2 and T3 was not statistically significant(P>0.05)between the two groups.?Comparison in groups:Compared with the time point of T1,the pH of the two groups decreased(P<0.05)at each time point of T2 and T3,while the PaCO2 and HCO3-increased(P<0.05).(3)Hemorheology Change:?Comparison between groups The difference in each index was not statistically significant(P>0.05)between the two groups at the time point of T0.These indexes in the group G+E were significantly lower than those in the group G(P<0.05)at the time points of T1,T2 and T3.?Comparison in groups:Compared with time point of T0,the indexes of the two groups decreased(P<0.05)at the time point of T1.The indexes in the group G did not change(P>0.05)at the time points of T2 and T3,and while they decreased(P<0.05)in the group G+E;Compared with the time point of T1,the indexes of the two groups increased(P<0.05)at the time points of T2 and T3.Conclusions:General anesthesia in combination with epidural block enhanced the deformability of the red blood cells in the body,reduced the aggregation performance of the red blood cells and effectively improved the hemorheological properties in the elderly patients with laparoscopic radical resection of colorectal cancer with high shear blood viscosity,low shear blood viscosity,viscosity of plasma,erythrocyte aggregation index,hematocrit and erythrocyte sedimentation rate.