The aim of this prospective, randomized clinical study is to compare between propofol and isoflurane on perioperative immune cell populations and function in patients undergoing total laryngectomy surgery.
The perioperative period might be a critical time in primary cancer surgery because many factors can affect whether recurrence, or metastasis , or elimination by the immune system. Cancer surgery can induce an acute inflammatory response, due to local tissue damage and the shedding of malignant cells into the blood and lymphocytic circulation although meticulous surgical manipulation. Many evidences suggest that several factors during the perioperative period can affect the immune system. These could be attributed to the surgery per se, pain, anxiety, hypothermia, blood transfusion, anesthetic technique, and anesthetic drugs .Impairment in the immune system may allow malignant cells to escape immuno-surveillance and metastasize in the perioperative period.As well as increase the risk of postoperative complications, such as systemic inflammatory response syndrome, sepsis, and multi-organ failure. Previous retrospective clinical studies of both breast and prostate cancer surgery have suggested an association between anaesthetic technique and cancer recurrence. However ,other retrospective trials on various forms of cancer have shown no such benefit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
40
Anesthesia is maintained with continuous infusion of propofol 1.5-2mg/kg/h and dexmedetomidine 0.2-1ug/kg/h.
Anesthesia was maintained with isoflurane at a concentration of 2-2.5%. fentanyl 50 ug increments
Mansoura University Hospitals, Ear Nose Thorat Department, Mansoura University
Al Mansurah, DK, Egypt
CD3 plasma level
Venous blood samples will be collected. The extracted venous blood samples will be mixed evenly in a special anti-coagulation test tube and stored in a refrigerator (at 4C).Flow cytometer will be used to detect the level of CD3+
Time frame: for 7 days after procedure
Heart rate
Intraoperative heart rate changes
Time frame: for 5 hours during the procedure
Blood pressure
Intraoperative blood pressure changes
Time frame: for 5 hours during the procedure
Peripheral oxygen saturation measured with pulse oximetry
Intraoperative peripheral oxygen saturation changes as measured with pulse oximetry
Time frame: for 5 hours during the procedure
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