Abstract:

AIM: To explore the effects of propofol combined with sevoflurane on kidney function and immune function in patients with cirrhosis after splenectomy. METHODS: Seventy-two cases in our hospital from May 2015 to May 2016 were divided into two groups: control group (36 cases) and observation group (36 cases) according to random number table method. Control group received propofol anesthesia, while observation group received sevoflurane combined with propofol. Liver function, renal function, immune function, stress reaction and anesthetic effects of two groups were observed and compared at before anesthesia, 2 h after anesthesia induction and 1 d after surgery. RESULTS: The spontaneous breathing recovery time, speech response time, orientation recovery time, blink time and extubation time in observation group were significantly shorter than those of control group (P＜0.01). After induction of anesthesia for 2 hours and after operation for 1 day, the level of ALT of observation group was much lower than that of control group, and ALB was much higher than that of control group (P＜0.05). The levels of BUN and Cr in observation group was much lower than these in control group (P＜0.05). The levels of CD4+ and CD4+/CD8+ in observation group was much higher than those in control group (P＜0.05). The levels of NE, NA and COR in control group was significantly increased after anesthesia (P＜0.05), while no differences were found in observation group (P＞0.05). The levels of NE, NA and COR in control group were much higher than those in observation group at 2 h after anesthesia induction and 1 d after surgery (P＜0.05) ［(241.43±22.15) ng/L vs. (196.74±18.47) ng/L, (230.86±20.28) ng/L vs. (191.13±17.59) ng/L; (352.38±29.47) ng/L vs. (247.84±21.23) ng/L, (341.65±27.87) ng/L vs. (241.64±20.52) ng/L; (253.13±25.95) ng/L vs. (131.37±15.53) ng/L, (231.91±19.97) ng/L vs. (128.93±15.15) ng/L］. CONCLUSION: The effects of sevoflurane combined with propofol on liver function, renal function and immune function in patients with liver cirrhosis is relatively mild, and the mechanism may be related to the reduction of stress response. The combination therapy is suitable for patients with cirrhosis.

Key words: cirrhosis, liver function, renal function, immune function, stress reaction, propofol, sevoflurane