麻醉诱导的免疫抑制在肿瘤手术中特别令人感兴趣。本研究旨在探讨4种最常见的全身麻醉技术对口腔癌皮瓣重建患者免疫功能的影响。116例患者被随机分为4组。 S组患者接受七氟烷麻醉。 P组采用丙泊酚麻醉。 SD组接受七氟烷联合右美托咪定麻醉。丙泊酚联合右美托咪定麻醉(PD)组接受PD。在5个时间点采集血样：基线（T0）、手术开始后1小时（T1）、手术结束（T2）、24小时（T3）和手术后48小时（T4）。通过流式细胞术分析淋巴细胞亚群（包括CD3、CD4、CD8和B淋巴细胞）和树突状细胞。分别使用ELISA和血气分析仪测量血糖、去甲肾上腺素和皮质醇水平。最终分析总共包括107名患者。 T1-4时S、P、SD组除CD8计数外的免疫学指标均较基线值下降，且CD3、CD4、树突状细胞计数及CD4/CD8比值均显着下降。 T1-3 时 PD 组高于 S、P 和 SD (P < .05)。 P组和SD组在任何观察时间点均无显着差异。 T1-2 时，PD 组的术中应激指数（包括去甲肾上腺素和皮质醇水平）显着低于其他 3 组（P < .05）。这些结果表明，PD 作为可能的最佳选择，可以减轻接受手术的患者的免疫抑制。口腔癌皮瓣重建。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

Anesthetic-induced immunosuppression is of particular interest in tumor surgery. This study aimed to investigate the influence of the 4 most common general anesthetic techniques on immune function in patients undergoing flap reconstruction for oral cancer.116 patients were randomly divided into 4 groups. Patients in group S were given sevoflurane-based anesthesia. Group P was administered propofol-based anesthesia. The SD group received sevoflurane combined with dexmedetomidine anesthesia. The propofol combined with dexmedetomidine anesthesia (PD) group received PD. Blood samples were obtained at 5 time points: baseline (T0), 1 hour after the start of the operation (T1), end of the operation (T2), 24 hours (T3), and 48 hours (T4) after the operation. Lymphocyte subsets (including CD3+, CD4+, CD8+, and B lymphocytes) and dendritic cells were analyzed by flow cytometry. Blood glucose, norepinephrine, and cortisol levels were measured using ELISA and a blood gas analyzer respectively.In total, 107 patients were included in the final analysis. Immunological indicators, except CD8+ counts, were all decreased in groups S, P, and SD at T1-4 compared with the baseline value, and the counts of CD3+, CD4+, and dendritic cells, as well as CD4+/CD8+ ratios, were significantly higher in the PD group than in the S, P, and SD at T1-3 (P < .05). There were no significant differences between groups P and SD at any observation time point. Intraoperative stress indices, including norepinephrine and cortisol levels, were significantly lower in the PD group than in the other 3 groups at T1-2 (P < .05).These findings suggest that PD as a probably optimal choice can alleviate immunosuppression in patients undergoing flap reconstruction for oral cancer.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.