Effect Of Sevoflurane On Peripheral Blood Lymphocyte Subsets In Elderly Patients Undergoing Radical Gastrectomy

Background: The incidence of tumors is increasing nowadays,and surgery is one of the main treatments for cancer patients,patients with good immune function will improve their survival rate greatly,and the number of lymphocytes in human peripheral blood can reflect the level of immune function.While the surgical stimulation,narcotic drugs and anesthetic technique during the perioperative period will affect the immune function in patients who have an operation.In order to investigate the effect of sevoflurane anesthesia on perioperative immune function in elderly patients undergoing laparoscopic radical gastrectomy,we observed the changes of peripheral blood lymphocyte subsets in elderly patients undergoing laparoscopic radical gastrectomy for sevoflurane to investigate the effect of sevoflurane anesthesia on perioperative immune function in elderly patients with gastric cancer.Methods: Through the approval of our institute's ethics committee,19 cases of gastric cancer patients aged between 60 and 80 years from November 2016 to February 2017 were selected,ASA grade ?-?.All patients were used for anesthesia with uniform administration standard,all the operations were the first one during the day,and conducted by the same group of the surgical doctors.We take the peripheral booods in patients at six time points below: 10 minutes before anesthesia induction(T1),5 minutes after anesthesia induction(T2),surgery starts instantly(T3),30 minutes after operation(T4),the end of operation and all the maintenance drugs were stopped(T5),24 hours after surgery(T6).The absolute value of T lymphocytes(CD3 +),B lymphocytes(CD19 +)and NK cells(CD16 + and / or CD56 +)in peripheral blood in patients were measured by flow cytometry(FCM),and the blood pressure,heart rate,pulse saturation,BIS at each time point were observed and recorded.Results:(1)Changes of vital signs: Compared T2?T3 with T1,the blood pressure,heart rate and BIS were decreased in T2 and T3,P <0.05,the results were statistically significant.Compared T3 with T2,the patient's blood pressure,heart rate were continue decreased in T3,there were statistical differences.Compared T5?T6 with T1,the patient's blood pressure,heart rate were recovered to preoperative levels.Compared T2 with T1,the BIS values of the patients were decreased in T2,the results were statistically significant.During the course of the procedure,the BIS values of the patients were maintained at a relatively constant state,and there was no significant difference in BIS values between T2,T3 and T4.Compared T5 with T4,BIS increased in T5,there were statistical differences.(2)The number of peripheral blood lymphocyte subsets in patients with peripheral blood: Compared T2?T3 with T1,the number of T lymphocytes(CD3 +),B lymphocytes(CD19 +),NK cells(CD3-CD16 + and / or CD56 +)in peripheral blood measured by flow cytometry,were decreased in T2?T3,P <0.05,the results were statistically significant;Compared T3 with T2,the number of T lymphocytes(CD3 +),B lymphocytes(CD19 +),NK cells(CD3-CD16 + and / or CD56+)were decreased in T3,P <0.05,there were statistical differences;Compared T4 with T3,the number of T lymphocytes(CD3+),B lymphocytes(CD19+),NK cells(CD3-CD16+ and / or CD56+)were increased in T4,the results were statistically significant;Compared T5 with T4,the number of T lymphocytes(CD3+),B lymphocytes(CD19+),NK cells(CD3-CD16+ and / or CD56 +)were decreased in T5,there were statistical differences;While compared T5 with T1,the number of both T cells and B cells not recovered to preoperative levels at the end of the procedure(T5),there were statistical differences;And compared T6 with T1,the number of both T cells ?B cells and NK cells not restored to preoperative levels at 24 hours after surgery(T6),P <0.05,the results were statistically significant.Conclusion: Sevoflurane inhalation anesthesia can decrease the number of lymphocytes in peripheral blood in elderly patients undergoing radical gastrectomy,and the inhibition effect occurs after anesthesia induction and increases gradually with the prolongation of inhalation time as well as the increase of inhalation gas of sevoflurane.The number of peripheral blood lymphocytes in elderly patients with gastric cancer increased significantly to a certain extent with surgical stimulation,but with the progress of surgery and prolonged anesthesia,peripheral blood lymphocytes will be significantly decreased,and failed to return to the levels before surgery at the end of surgery as well as 24 hours after surgery.