Application of sevoflurane combined with remifentanil anesthesia in laparoscopic radical hysterectomy for cervical cancer

Am J Transl Res. 2022 Nov 15;14(11):8361-8370. eCollection 2022.

Abstract

Objective: To explore the effects of sevoflurane combined with remifentanil anesthesia on the physical stress and immunologic function of patients undergoing laparoscopic radical hysterectomy for cervical cancer.

Methods: The clinical data of 74 patients undergoing laparoscopic radical hysterectomy for cervical cancer were retrospectively analyzed. Patients were divided into two groups according to the different anesthesia methods, among which 37 cases received propofol and remifentanil anesthesia were set as a control group (CG), and 37 cases received sevoflurane and remifentanil anesthesia were set as an observation group (OG).

Results: The OG showed a lower heart rate, Ramsay score and bispectral index than the CG 30 min after the start of the surgery and at the end of the surgery. The levels of glucagon, angiotensin II and cortisol in the OG were lower than those in the CG upon skin incision, at the end of surgery, and at 1 h after surgery (P < 0.05). The levels of CD3+ and CD4+ of the OG were higher than those of the CG at 1 d and 3 d after surgery. In terms of Montreal Cognitive Assessment and Mini-Mental State Examination scores 1 d after surgery, the OG was higher than the CG.

Conclusion: Sevoflurane combined with remifentanil anesthesia for patients undergoing laparoscopic radical hysterectomy for cervical cancer is superior to propofol and remifentanil, and can ensure stable hemodynamics and mitigate physical stress, so it is worthy of clinical application.

Keywords: Laparoscopic radical hysterectomy; cervical cancer; cognitive function; immunologic function; physical stress; remifentanil; sevoflurane.