Combined anesthesia shows better curative effect and less perioperative neuroendocrine disorder than general anesthesia in early stage NSCLC patients

• Published in: Journal of international medical research Vol. 47; no. 10; pp. 4743 - 4752
• Main Authors: Pi, Jingbo, Sun, Yi, Zhang, Zhenghong, Wan, Chengfu
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2019; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Aged; Anesthesia, General - adverse effects; beta-Endorphin - blood; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - physiopathology; Carcinoma, Non-Small-Cell Lung - surgery; Case-Control Studies; Clinical Research Reports; Cytokines - blood; Female; Hemodynamics; Humans; Inflammation Mediators - blood; Lung cancer; Lung Neoplasms - blood; Lung Neoplasms - pathology; Lung Neoplasms - physiopathology; Lung Neoplasms - surgery; Male; Malondialdehyde - blood; Middle Aged; Neoplasm Staging; Neurosecretory Systems - pathology; Time Factors; Treatment Outcome; Tumor necrosis factor-TNF; Visual Analog Scale; inflammatory response; long-term outcome; combined epidural and general anesthesia; general anesthesia; tumor resection; Early stage non-small cell lung carcinoma
• ISSN: 0300-0605; 1473-2300; 1473-2300
• DOI: 10.1177/0300060519862102

Objectives We aimed to compare the effects of general anesthesia with combined epidural and general anesthesia in patients with early-stage non-small cell lung carcinoma (NSCLC). Methods Patients scheduled to undergo tumor resection with adjuvant chemoradiotherapy were eligible. Patients in the control group received general anesthesia during surgery, and those in the observation group received combined epidural and general anesthesia. The hemodynamic factors mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, and oxygen saturation were measured. Serum levels of pro-inflammatory cytokines interleukin (IL)-1, IL-8, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor (TNF)-α as well as β-endorphin were measured by enzyme-linked immunosorbent assay. Serum malondialdehyde (MDA) was measured using the thiobarbituric acid method. Results The incidence of specific adverse events was reduced and overall and disease-free survival were improved in the observation group compared with the control group. MAP was generally lower in the observation group compared with the control group, as were the serum levels of IL-1, IL-8, hs-CRP, TNF-α, and MDA. Conclusions Compared with general anesthesia, combined epidural and general anesthesia may inhibit the occurrence of short-term adverse events and improve long-term outcomes by inhibiting inflammatory responses in patients with early-stage NSCLC after tumor resection.