Effects of Different Anaesthesia Methods on Perioperative Cellular Immune Function and Long-term Outcomes in Patients Undergoing Radical Resection of Esophageal Cancer: A Prospective Cohort Study

Abstract Background The present study aimed to analyse the effects of different an anaesthetic method on perioperative cellular immunity and long-term outcomes in patients having undergone oesophageal cancer surgery.Design A Prospective Cohort StudyParticipants 120 cases of patients with oesophageal cancer in the Zhengzhou University People’s Hospital from January 2016 to January 2017 were recruited and randomly split into GA group (general anaesthesia, n=40), PG group (Paravertebral nerve blocks with general anaesthesia, n = 40) and EG group (epidural anaesthesia with general anaesthesia, n=40). Methods Self-rating anxiety scale and visual analogue scale scores were adopted to compare postoperative anxiety and the degree of pain of patients of the three groups. Besides, adverse reactions of patients in the three groups were compared. Pre-operation, the end of operation, postoperative day (POD) 1 and POD 2 levels of interleukin-6 (IL-6), IL-4, tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and the survival of T-cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were measured with by either ELISA or flow cytometry.Results In the PG or EG group, VAS scores were lower, and fewer opioids and vasoactive agents were used, as compared with those of the GA group. In both the EG and PG groups, higher CD3+ and CD4+ cell survival and lower levels of Cor, IL-4 and IL-6 were identified at the end of or after the surgery than those in the GA group. Moreover, the postoperative survival cure of the PG and EG groups was better than that of the GA group.Conclusions The combination of paravertebral nerve blocks or epidural anaesthesia and general anaesthesia may improve the perioperative immune function and the long-term outcome for patients having undergone oesophageal cancer surgery.