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
ARTICLE HIGHLIGHTS
Research background

Rectal carcinoma (RC) is a major health problem with an increasing incidence. The primary treatment is laparoscopic surgery, which can induce significant hemodynamic changes and weaken immune function. Anesthesia often involves opioid drugs such as remifentanil and sufentanil that may cause hypotension.

Research motivation

It is necessary to understand the impact of different anesthesia methods on hemodynamics and oxidative stress during RC. Investigating the effects of remifentanil combined with propofol may offer insights into the best management of patient health during and after surgery.

Research objectives

The primary objective of this study was to determine the effects of remifentanil combined with propofol on hemodynamics and oxidative stress in patients undergoing RC resection.

Research methods

A retrospective analysis was conducted using the data of 104 patients with RC who were treated at a hospital between November 2018 and November 2022. Patients were divided into two groups based on the type of anesthesia received: Remifentanil and sufentanil. Various factors were compared between the two groups, including changes in hemodynamic indices, oxidative stress indices, general data, consumption of remifentanil, and use of vasoactive agents.

Research results

The remifentanil group had a notably lower heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure, plasma cortisol, noradrenaline, and glucose levels during different stages of surgery than the sufentanil group. The remifentanil group also consumed less remifentanil and showed lower adoption of ephedrine. Moreover, the sufentanil group showed a notably higher incidence of hypotension compared with the remifentanil group.

Research conclusions

The combined use of remifentanil and propofol can improve hemodynamics and relieve oxidative stress for patients undergoing RC resection. Specifically, the remifentanil group demonstrated lower HR, blood pressure, and stress hormone levels and experienced fewer instances of hypotension than the sufentanil group. In addition, the remifentanil group consumed less remifentanil and had a lower frequency of ephedrine use. These findings suggest that a combination of remifentanil and propofol may be a feasible and beneficial anesthetic approach for such surgical procedures. However, the applicability of these conclusions to patients with severe hypertension or cardiovascular or cerebrovascular disease remains unclear and requires further investigation.

Research perspectives

Remifentanil combined with propofol can improve hemodynamics and relieve oxidative stress in patients undergoing RC resection. However, the conclusions of this study might not apply to patients with severe hypertension or cardiovascular or cerebrovascular diseases owing to the research limitations. Further research with a more diverse patient sample and a prospective study design is recommended to verify these findings.