Effect Of Intraoperative Maintenance Of Propofol Or Sevoflurane On The Prognosis Of Patients Undergoing Thoracoscopic Radical Resection Of Lung Cancer

Objective:Enhanced recovery after surgery(ERAS)refers to the application of a series of evidence-based medical treatment methods in the perioperative period to reduce the patient’s surgical stress、complications and pain,shorten the hospital stay,and improve the long-term outcome of the patient.This article compares a series of rapid recovery and tumor prognostic indicators for lung cancer patients undergoing volatile or intravenous anesthesia.Methods:Patients undergoing thoracoscopic radical resection of lung cancer were divided into propofol-based total intravenous anesthesia or sevoflurane-based inhalation anesthesia.Propofol was used to maintain anesthesia(4-12mg/kg·h).In the inhalation anesthesia group,sevoflurane was used to maintain anesthesia(1.0-1.5MAC).A series of clinical rapid recovery indicators was observed during the perioperative period of the two groups of patients;the concenreation of serum MMP-9 and IL-22 before operation,immediately after stopping the anesthetics and 24 h after operation was detected;neutrophil-lymphocyte ratio and platelet-lymphocyte ratio at preoperative,24 h,48h,72 h postoperatively was recorded;postoperative NRS score,nausea and vomiting,dizziness,respiratory complications,chronic pain and survival situation.Results:The lowest mean arterial pressure in the propofol group was significantly higher than that in the sevoflurane group(P <0.01).The time to get out of bed in the sevoflurane group was significantly later than that in the propofol group(P <0.05).The concentration of MMP-9 in the sevoflurane group increased significantly at 24 h after surgery(P <0.01).The proportion of platelets and lymphocytes in the propofol group was significantly lower than that in the sevoflurane group at 48 hours after surgery(P <0.05).There were no significant differences in postoperative NRS scores,adverse reaction rates and overall survival between the two groups.Conclusion:Propofol-based total intravenous anesthesia can enhanced recovery after surgery,and reduce the serum concentration of tumor-related inflammatory factors.