EFFECT OF TOTAL INTRAVENOUS ANESTHESIA FOR THE STRESS REACTION ON OLD PATIENT SUFFERING FROM ESOPHAGEAL CARCINOMA

Objective:To observe the influence of different anesthesia patterns(total intravenous anesthesia and intravenous combined with inhalation anesthesia)on the tress response of the elder with esophageal carcinoma.Methods:60 cases of elderly patients with esophageal carcinoma were randomly divided into two groups A and B.Group A was total intravenous anesthesia by TCI(30 cases).Group B was intravenous combined with inhalation anesthesia(30 cases).After the same induction of anesthesia.Group A:target plasma concentration of propofol at 2.0~3.0ug/mL and fentanyl at 1.5~2.0μg/mL for the maintenance of anesthesia.Group B inhale isoflurane 1.5~2.0% and injecx fentanyl 0.05mg per time intermittently.During the two groups' operation,monitor bispectral and maintain it between 45~50 by adjusting the infusion rate of propofol and remifentanil in group A and inhalate adequate concentration of isoflurane in group B.Then to monitor MBP,HR,SpO2 and CVP conventionally.Vein blood samples were obtained before induction of anesthesia(T1),at 2h in surgery(T2),at the end of surgery(T3),at 24h after surgery(T4)for determination of the plasma level of norepinephrine(NE),cortisol(COR),C-reactive protein(CRP)and blood glucose(Glu).Results:There was no significant difference in all index level at T1 between the two groups.Along with the operation NE and CRP were significantly lower at the last there times In groups A than in Group B(P0.05).COR and Glu were also significantly lower at T2 and T3 In groups A than in Group B(P0.05).Conclusion:Surgery will increase the patient's stress response.But stress response was lighter and circulation was steadier in total intravenous anesthesia by TCI than in intravenous combined with inhalation anesthesia.so total intravenous anesthesia by TCI is an ideal method for surgery of elderly patients with esophageal carcinoma.