Influence of different methods of anesthesia on glucose metabolism of leukocytes in elderly patients undergoing colorectal cancer surgery

Abstract

Objective To evaluate the influence of different methods of anesthesia on the glucose metabolism of leukocytes in elderly patients undergoing colorectal cancer surgery. Methods Fifty ASA Ⅰ or Ⅱ patients, aged≥65 yr, with body mass index 18-25 kg/m2, scheduled for elective colorectal cancer surgery, were randomly divided into 2 groups ( n = 25 each) : sevoflurane anesthesia group (Sevo group) and sevoflurane anesthesia combined with epidural block group ( S + E group) . The patients in S + E group underwent epidural catheterization, and 2% lidocaine 3 ml was given via the epidural catheter. If no signs of spinal anesthesia were confirmed 5 min later, the mixture of 1% lidocaine and 0.2% tetracaine 8-10 ml was given, and an increment of the mixture 4-5 ml was given every 50 min. During the operation, the end-tidal concentration of sevoflurane was maintained at 0.7 MAC in S + E group and at 1.0 MAC in Sevo group. The depth of anesthesia was adjusted according to the BIS value in both groups. Venous blood samples were taken at 10 min before operation (T1 ), and 60 min, 24 h.and 5 days after the end of operation (T2-4 ) for WBC count and measurement of activities of pyruvate kinase (PK)and glucose-6-phosphate dehydrogenase (G6PD) in the leukocytes. Results Compared with T1, the WBC count at T3 in both groups, the PK activity at T, in group S+E and G6PD activity at T, in group Sevo and at T3,4 in group S + E were significantly increased ( P ＜ 0.01) . Compared with group Sevo, the PK activity at T, and G6PD activity at T3,4 were significantly increased in group S+E ( P ＜ 0.05) . There was no significant difference in the WBC count between the two groups ( P ＞ 0.05) . Conclusion There is no significant change in the WBC count when the two methods of anesthesia are used in elderly patients undergoing colorectal caner surgery, however, sevoflurane anesthesia combined with epidural block enhances the leukocyte function in elderly patients compared with sevoflurane anesthesia alone. Key words: Anesthesia; Leukocytes; Pyruvate kinase; Glucosephosphate dehydrogenase; Aged