Effect of intravenous infusion of lidocaine combined with magnesium sulfate on perioperative immunological stress in gener-al anesthesia patients undergoing laparoscopic surgery
Objective To evaluate the effect of intravenous infusion of lidocaine combined with magnesium sulfate on periop-erative immunological stress in patients undergoing laparoscopic surgery with general anesthesia.Methods Seventy-six patients,aged 18-65 y,of the American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing laparoscopic surgery with general anes-thesia,were divided into 2 groups(n=38)according to the random number table mothod:experiment group(group L)and control group(group C).The group C received intravenous anesthesia only,while the group L received intravenous anesthesia combined with intrave-nous infusion of lidocaine combined with magnesium sulfate.Their general information were recorded(including age,height,weight,surgery time and anesthesia time);the percentages of CD3+T cells,CD4+T cells,CD8+T cells,natural killer(NK)cells,B cells,and CD4+/CD8+at the time points of entry(T1),after extubation(T2),and 2 d after surgery(T3)for two groups of patients.Enzyme-linked im-munosorbent assay(ELISA)was used to detect the concentrations of plasma high-sensitivity C-reactive protein(hs-CRP),interferon-γ(IFN-γ),prostaglandin F2(PGF2a),and prostaglandin E2(PGE2)in two groups of patients.The 15-item Quality of Recovery(OoR-15)score and postoperative hospital stay time were recorded.Results There was no statistical difference in general information between two groups(all P＞0.05).The QoR-15 score at T3 in group L is higher than that in group C(P＜0.05),while there is no significant differ-ence in postoperative hospital stay time between the two groups(P＞0.05).Compared with the percentage at T1:the percentage of CD3+T cells,CD4+T cells,and CD4+/CD8+in group C decreased at T2(all P＜0.05),while the percentage of NK cells increased(P＜0.05)at T2;the percentage of NK cells in group L increased(P＜0.05)at T2 but decreased at T3(P＜0.05),the percentage of CD4+T cells and B cells increased(all P＜0.05)at T3.Compared with the percentages at T2:the percentages of CD3+T cells,CD4+T cells,and B cells in-creased in both groups at T3(all P＜0.05),the percentage of NK cells decreased(P＜0.05);the percentage of CD4+/CD8+increased in group C at T3(P＜0.05).Compared with group C,group L had a higher percentage of CD4+T cells but a lower percentage of NK cells at T2 and T3(all P＜0.05).Group L had a higher percentage of CD3+T cells at T2 than the percentage in group C(all P＜0.05).Compared with T1:the concentrations of hs-CRP and IFN-γ increased in both groups at T3(all P＜0.05),while the concentrations of PGF2 α and PGE2 decreased in group L at T2(all P＜0.05).Compared with T2:the concentrations of hs-CRP and IFN-γ increased in both groups at T3(all P＜0.05),and the concentrations of PGF2α and PGE2 increased in group L at T3(all P＜0.05).Compared with group C:the con-centrations of PGF2α and PGE2 decreased in group L at T2(all P＜0.05),and the concentrations of hs-CRP and IFN-γ decreased in group L at T3(P＜0.05).There was no significant difference in other indexes between the two groups(all P＞0.05).Conclusions Intra-venous infusion of lidocaine combined with magnesium can reduce perioperative immunological stress and benefit postoperative recov-ery in patients undergoing laparoscopic surgery with general anesthesia.
LidocaineMagnesium sulfateImmuneStressGeneral anesthesiaLaparoscopy surgery
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