Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2774-2782
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2774
Effects of remifentanil combined with propofol on hemodynamics and oxidative stress in patients undergoing resection of rectal carcinoma
Jing Huang, Wen-Jun Tian
Jing Huang, Department of First Anesthesiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Wen-Jun Tian, Department of Fourth Anesthesiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Author contributions: Huang J and Tian WJ contributed to the experimental design and implementation; Huang J contributed to the data curation; Huang J and Tian WJ contributed to the writing-original draft preparation and writing-review and editing; all authors have reviewed and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University.
Informed consent statement: This reaearch is a retrospective study that only used anonymous patient data from the hospital system for analysis, and will not cause any adverse harm to patients. We have applied to the hospital ethics committee for exemption from the patient's informed consent form.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Jun Tian, MM, Attending Doctor, Department of Fourth Anesthesiology, the First Affiliated Hospital of Dalian Medical University, No. 193 Shahekou District, Dalian 116011, Liaoning Province, China. wenjun8907@163.com
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 8, 2023
Revised: November 20, 2023
Accepted: December 1, 2023
Article in press: December 1, 2023
Published online: December 27, 2023
Processing time: 65 Days and 9.9 Hours
Abstract
BACKGROUND

Rectal carcinoma (RC) treatment primarily involves laparoscopic surgery, which may induce significant hemodynamic changes and weaken immune function. Certain anesthetic approaches using opioid drugs (including remifentanil and sufentanil) pose risks, such as hypotension.

AIM

To determine the effects of remifentanil combined with propofol on hemodynamics and oxidative stress in patients undergoing RC resection.

METHODS

A total of 211 patients one hundred and four patients with RC treated at the First Affiliated Hospital of Dalian Medical University between November 2018 and November 2022 were retrospectively analyzed. Among them, the remifentanil group included 45 patients receiving remifentanil with propofol anesthesia and the sufentanil group included 59 patients receiving sufentanil with propofol anesthesia. Changes in the hemodynamic index, oxidative stress index, general data, consumption of remifentanil, and use of vasoactive drugs were compared. The incidences of adverse reactions were calculated.

RESULTS

The two groups did not significantly differ in terms of operation, anesthesia, and extubation times (P > 0.05). At 1 min after intubation, the sufentanil group showed a notably higher heart rate, systolic blood pressure (SBP), diastolic blood pressure, and mean arterial pressure (MAP) compared with the remifentanil group (P < 0.05), whereas the sufentanil group showed a notably higher SBP and MAP compared with the remifentanil group at 5 min after pneumoperitoneum (P < 0.05). Thirty minutes after surgery, the remifentanil group showed significantly lower plasma cortisol, noradrenaline, and glucose levels than the sufentanil group (P < 0.001). The remifentanil group consumed significantly less remifentanil than the sufentanil group (P < 0.05), and the adoption frequency of ephedrine was lower in the remifentanil group than that in the sufentanil group (P < 0.05). The incidence of hypotension was notably higher in the sufentanil group than that in the remifentanil group (P < 0.05).

CONCLUSION

Remifentanil combined with propofol can improve hemodynamics and relieve oxidative stress in patients undergoing RC resection.

Keywords: Remifentanil; Propofol; Resection of rectal carcinoma; Hemodynamics; Oxidative stress; Sufentanil

Core Tip: This study evaluated the effects of remifentanil combined with propofol on the hemodynamics and oxidative stress in patients undergoing rectal carcinoma surgery. These findings indicate that this combination improves hemodynamic stability, reduces oxidative stress, and results in a lower incidence of hypotension compared with sufentanil alone. Furthermore, the remifentanil-propofol combination requires less remifentanil consumption and reduced use of ephedrine, suggesting that it is a more effective and potentially safer anesthetic approach for these surgeries.