Effect of Etomidate and Propofol on Serum Inflammatory Factors of Patients with Lung Adenocarcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUJia-peng , DONGWei , WANGTao , SUNPeng , YUJian-jian ,  HANJian-ge

Department of anesthesiology of Tianjin Chest Hospital, Tianjin 300000, P. R. China;

Corresponding author：

HANJian-ge, Email: hanjiange@163.com

Keywords：

Etomidate; Propofol; Inflammatory cytokines; General anesthesia

DOI：

10.7507/1007-4848.20160247

Video：

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Objective To investigate the effect of etomidate and propofol on inflammatory cytokines and cortisol for patients with lung adenocarcinoma. Method Sixty patients scheduled for lung cancer surgery under general anesthesia were studied. All patients were randomly divided into an etomidate total intravenous anesthesia group (group E, 30 patients, 16 males and 14 females at age of 58.0±5.0 years) and a propofol total intravenous anesthesia group (group P, 30 patients, 17 males and 13 females at age of 55.0±5.0 years), with 30 patients in each group. Results The concentration of IL-6 in serum of patients in the two groups at time points T₁, T₂ and T₃ was significantly higher than those at time point T₀ (P < 0.01). The concentration of IL-10 and TNF-α in serum of patients at time points T₁ and T₂ was significantly higher than those at time point T₀ (P < 0.01). And the difference of the concentration of TNF-α in serum of patients at time points T₀ and T₃ was not statistically significant (P > 0.05). The level of Cor of patients in the group E at time point T₀ was slightly higher than those at time point T₁, but lower than that at time points T₂ and T₃. There was no statistical difference in the concentration of IL-6 and TNF-α in serum of patients between the two groups. The level of IL-10 of patients in the group E at time points T₂ and T₃ was lower than those in the group P (P < 0.05), but no significant difference was observed at the other time points. The concentration of Cor in the patients in the group E at time point T₁ was lower than that in the group P (P < 0.01), but no significant difference was observed either at the other time points. Conclusion The effect of etomidate used for maintenance of general anesthesia on the inflammatory factors is essentially similar to that of propofol.

Citation： LIUJia-peng, DONGWei, WANGTao, SUNPeng, YUJian-jian, HANJian-ge. Effect of Etomidate and Propofol on Serum Inflammatory Factors of Patients with Lung Adenocarcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(11): 1050-1054. doi: 10.7507/1007-4848.20160247 Copy

1.	Allemani C, Weir HK, Carreira H, et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25, 676, 887 patients from 279 population-based registries in 67 countries. The Lancet, 2015, 385(9972): 977-1010.
2.	Rybojad P, Jabłonka A, Wilczyńska B, et al. Surgery decreases num-ber of cells secreting cytotoxic mediators and increases secretion of interleukin 10 in patients with lung cancer. Eur J Surg Oncol. 2013, 39(11):1269-1277.
3.	Merquiol F, Montelimard AS, Nourissat A, et al. Cervical epidural anesthesia is associated with increased cancer-free survival in laryn-geal and hypopharyngeal cancer surgery:a retrospective propensity-matched analysis. Reg Anesth Pain Med, 2013, 38(5): 398-402.
4.	Cata JP, Bauer M, Sokari T, et al. Effects of surgery, general anesth-esia, and perioperative epidural analgesia on the immune function of patients with non-small cell lung cancer. J Clin Anesth, 2013, 25 (4): 255-262.
5.	Lacassie HJ, Cartagena J, Branes J, et al. The relationship between neuraxial anesthesia and advanced ovarian cancer-related outcomes in the Chilean population. Anesth Analg, 2013, 117(3): 653-660.
6.	顾卫东, 景华, 常春林, 等. 160例70岁以上高龄普胸手术患者围术期处理.中国胸心血管外科临床杂志, 2004, 11(4): 306-307.
7.	Payen JF. Etomidate for critically ill patients: let us clarify the debate. Eur J Anaesthesiol, 2012, 29(11): 504-505.
8.	Song JC, Lu ZJ, Jiao YF, et al. Etomidate anesthesia during ERCP caused more stable haemodynamic responses compared with propofol: a randomized clinical trial. Int J Med Sci, 2015, 12(7): 559-565.
9.	Weng D, Huang M, Jiang R, et al. Clinical study of etomidate emul-sion combined with remifentanil in general anesthesia. Drug Des Devel Ther, 2013, 20(7): 771-776.
10.	Moody EJ, Knauer CS, Granj AR, et al. Distinct structural requirements for direct and indirectactions of the anaesthetic etomidate at GABAA receptors. Toxicol Lett, 1998, 100-101(3): 209-215.
11.	Vanacker B, Wicbalck A, Aken HV, et al. Quality of induction and adrenocortical function: a clinical comparison of Etomidate-Lipuro and Hypnomidate. Anaesthesist, 1993, 42(42): 81-89.
12.	Banihashem N, Alijanpour E, Basirat M, et al. Sedation with etomidate-fentanyl versus propofol-fentanyl in colonoscopies: A prospective randomized study. Caspian J Intern Med, 2015, 6(1): 15-19.
13.	Shah SB, Chowdhury I, Bhargava AK, et al. Comparison of hemod-ynamic effects of intravenous etomidate versus propofol during induction and intubation using entropy guided hypnosis levels. J Anaesthesiol Clin Pharmacol, 2015, 31(2): 97-112.
14.	Luan HF, Zhao ZB, Feng JY, et al. Prevention of etomidate-induced myoclonus during anesthetic induction by pretreatment with dexmedetomidine. Braz J Med Biol Res, 2015, 48 (2): 186-190.
15.	He L, Ding Y, Chen H, et al. Dezocine pretreatment prevents myoclonus induced by etomidate: a randomized, double-blinded controlled trial. J Anesth, 2015, 29(1): 143-145.
16.	Safavi M, Honarmand A, Sahaf AS, et al. Magnesium sulfate versus Lidocaine pretreatment for prevention of pain on etomidate injection: A randomized, double-blinded placebo controlled trial. J Res Pharm Pract, 2015, 4(1): 4-8.
17.	Weng D, Huang M, Jiang R, et al. Clinical study of etomidate emulsion combined with remifentanil in general anesthesia. Drug Des Devel Ther, 2013, 7(1): 771-776.
18.	Pejo E, Feng Y, Chao W, et al. Differential effects of etomidate and its pyrrole analogue carboetomidate on the adreno-cortical and cytokine responses to endotoxemia. Crit Care Med, 2012, 40(40): 187-192.
19.	Yeager MP, Rassias AJ, Fillinger MP, et al. Cortisol antiinflammatory effects are maximal at postoperative plasma concentrations. Crit Care Med, 2005, 33(7): 1507-1512.
20.	Long C, Xuan Z, Chen XY, et al. Propofol attenuates the level of TNF-α, IL-6 and IL-10 in LPS-induced acute lung injury in rats. J Clin Anesthesiol, 2011, 27(8): 815-817.
21.	Wagner CE, Bick JS, Johnson D, et al. Etomidate use and postoperative outcomes among cardiac surgery patients. Anesthesiology, 2014, 120(3): 579-589.
22.	Elliot M, Brown G, Kuo IF. Does etomidate increase vasopressor requirements in patients needing mechanical ventilation? Can J Hosp Pharm, 2012, 65(4):272-276.

1. Allemani C, Weir HK, Carreira H, et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25, 676, 887 patients from 279 population-based registries in 67 countries. The Lancet, 2015, 385(9972): 977-1010.
2. Rybojad P, Jabłonka A, Wilczyńska B, et al. Surgery decreases num-ber of cells secreting cytotoxic mediators and increases secretion of interleukin 10 in patients with lung cancer. Eur J Surg Oncol. 2013, 39(11):1269-1277.
3. Merquiol F, Montelimard AS, Nourissat A, et al. Cervical epidural anesthesia is associated with increased cancer-free survival in laryn-geal and hypopharyngeal cancer surgery:a retrospective propensity-matched analysis. Reg Anesth Pain Med, 2013, 38(5): 398-402.
4. Cata JP, Bauer M, Sokari T, et al. Effects of surgery, general anesth-esia, and perioperative epidural analgesia on the immune function of patients with non-small cell lung cancer. J Clin Anesth, 2013, 25 (4): 255-262.
5. Lacassie HJ, Cartagena J, Branes J, et al. The relationship between neuraxial anesthesia and advanced ovarian cancer-related outcomes in the Chilean population. Anesth Analg, 2013, 117(3): 653-660.
6. 顾卫东, 景华, 常春林, 等. 160例70岁以上高龄普胸手术患者围术期处理.中国胸心血管外科临床杂志, 2004, 11(4): 306-307.
7. Payen JF. Etomidate for critically ill patients: let us clarify the debate. Eur J Anaesthesiol, 2012, 29(11): 504-505.
8. Song JC, Lu ZJ, Jiao YF, et al. Etomidate anesthesia during ERCP caused more stable haemodynamic responses compared with propofol: a randomized clinical trial. Int J Med Sci, 2015, 12(7): 559-565.
9. Weng D, Huang M, Jiang R, et al. Clinical study of etomidate emul-sion combined with remifentanil in general anesthesia. Drug Des Devel Ther, 2013, 20(7): 771-776.
10. Moody EJ, Knauer CS, Granj AR, et al. Distinct structural requirements for direct and indirectactions of the anaesthetic etomidate at GABAA receptors. Toxicol Lett, 1998, 100-101(3): 209-215.
11. Vanacker B, Wicbalck A, Aken HV, et al. Quality of induction and adrenocortical function: a clinical comparison of Etomidate-Lipuro and Hypnomidate. Anaesthesist, 1993, 42(42): 81-89.
12. Banihashem N, Alijanpour E, Basirat M, et al. Sedation with etomidate-fentanyl versus propofol-fentanyl in colonoscopies: A prospective randomized study. Caspian J Intern Med, 2015, 6(1): 15-19.
13. Shah SB, Chowdhury I, Bhargava AK, et al. Comparison of hemod-ynamic effects of intravenous etomidate versus propofol during induction and intubation using entropy guided hypnosis levels. J Anaesthesiol Clin Pharmacol, 2015, 31(2): 97-112.
14. Luan HF, Zhao ZB, Feng JY, et al. Prevention of etomidate-induced myoclonus during anesthetic induction by pretreatment with dexmedetomidine. Braz J Med Biol Res, 2015, 48 (2): 186-190.
15. He L, Ding Y, Chen H, et al. Dezocine pretreatment prevents myoclonus induced by etomidate: a randomized, double-blinded controlled trial. J Anesth, 2015, 29(1): 143-145.
16. Safavi M, Honarmand A, Sahaf AS, et al. Magnesium sulfate versus Lidocaine pretreatment for prevention of pain on etomidate injection: A randomized, double-blinded placebo controlled trial. J Res Pharm Pract, 2015, 4(1): 4-8.
17. Weng D, Huang M, Jiang R, et al. Clinical study of etomidate emulsion combined with remifentanil in general anesthesia. Drug Des Devel Ther, 2013, 7(1): 771-776.
18. Pejo E, Feng Y, Chao W, et al. Differential effects of etomidate and its pyrrole analogue carboetomidate on the adreno-cortical and cytokine responses to endotoxemia. Crit Care Med, 2012, 40(40): 187-192.
19. Yeager MP, Rassias AJ, Fillinger MP, et al. Cortisol antiinflammatory effects are maximal at postoperative plasma concentrations. Crit Care Med, 2005, 33(7): 1507-1512.
20. Long C, Xuan Z, Chen XY, et al. Propofol attenuates the level of TNF-α, IL-6 and IL-10 in LPS-induced acute lung injury in rats. J Clin Anesthesiol, 2011, 27(8): 815-817.
21. Wagner CE, Bick JS, Johnson D, et al. Etomidate use and postoperative outcomes among cardiac surgery patients. Anesthesiology, 2014, 120(3): 579-589.
22. Elliot M, Brown G, Kuo IF. Does etomidate increase vasopressor requirements in patients needing mechanical ventilation? Can J Hosp Pharm, 2012, 65(4):272-276.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of Etomidate and Propofol on Serum Inflammatory Factors of Patients with Lung Adenocarcinoma

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