Effects of Dezocine-Remifentanil Intravenous Anaesthesia on Perioperative Signs, Serum TNF-&aipha; and IL-6 in Liver Cancer Patients undergoing Radiofrequency Ablation

Abstract

Objective: To analyse the impact of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum tumour necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in liver cancer patients undergoing radiofrequency ablation (RFA).

Study design: An experimental study.

Place and duration of study: Renmin Hospital of Wuhan University, Wuhan, China, from January 2017 to February 2018.

Methodology: Eighty patients with small hepatocellular carcinoma (SHCC) were selected as the research object. They were divided into Group A and Group B with the random number table method, with 40 cases in each group. Group A were given dezocine-remifentanil intravenous anaesthesia and Group B were given midazolam-remifentanil intravenous anaesthesia. Patients' situations in the surgery were compared between the two groups. Changes in heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO₂) were recorded before the surgery (T₀), at 5 minutes after the RFA (T₁) and at the end of the RFA (T₂). Levels of tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) on the 1² day after the RFA were compared between the two groups.

Results: The wake-up time in Group A was shorter than Group B (p<0.001), and the VAS pain score in Group A was lower than Group B (p<0.001). At T₁, the MAP in Group A was higher than Group B (p<0.001). There was no significant difference in MAP between the two groups at T₀ and T₂ (p=0.881, 0.696, respectively). At T₁ and T₂, the HR in Group A was lower than Group B (all p<0.001). There was no significant difference in HR between the two groups at T₀ (p=0.684). There was no significant difference in SpO₂ between the two groups at T₀, T₁ and T₂ (p=0.654, 0.884 and 0.798, respectively). On the 1st day after the RFA, the level of TNF-&alpha;, IL-6 in Group A were lower than those of Group B (all p<0.001). There was no significant difference in the incidence of intraoperative complications between the two groups (p=0.644).

Conclusion: Compared with midazolam-remifentanil intravenous anaesthesia, the dezocine-remifentanil method has a better analgesic effect, shorter wake-up time, and can effectively regulate the expression of inflammatory cytokines TNF-&alpha; and IL-6. However, the effect of remifentanil on the respiratory function is dose-dependent. Therefore, respiratory cycle monitoring and management should be strengthened during the surgery.