Effects of propofol combined with remifentanil anesthesia on the NO, endothelin and inflammatory cytokines in the plasma of patients with liver cirrhosis during the perioperative period

The effects of propofol combined with remifentanil on the nitric oxide (NO), endothelin (ET-1) and inflammatory cytokines in the plasma of patients with liver cirrhosis were investigated. A retrospective analysis of 68 patients with liver cirrhosis who underwent hepatectomy in the Hunan Provincial People's Hospital from March 2016 to July 2018 was made. According to different anesthesia methods, 30 patients anesthetized with propofol were enrolled into Group A. The other 38 patients anesthetized with propofol combined with remifentanil were enrolled into Group B, and the operation time, amount of bleeding during operation and postoperative awake time of the two groups were recorded. At three separate time-points T(1) (30 min before the anesthesia), T(2) (after the portal triad clamping), T(3) (3 days after the operation), aspartate transaminase (AST) and alanine transaminase (ALT) levels in the plasma were measured by rate method, and the levels of NO, ET-1, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in plasma were detected by enzyme-linked immunosorbent assay (ELISA). The plasma NO levels at the T(2) time-point were significantly lower than those at the T(1) and T(3) time-points (P<0.05); at the T(2) time-point, the concentrations of AST, ALT, ET-1, IL-6 and TNF-α in the plasma in Group A were significantly higher than those of Group B (P<0.05), while the levels of plasma NO in Group A were the opposite (P<0.05). The anesthesia of propofol combined with remifentanil could contribute to the balance of NO/ET-1 and the inhibition of inflammatory factors during the hepatectomy operation in patients with liver cirrhosis, and help to protect the liver function of patients, reducing the incidence of liver ischemia-reperfusion injury in patients.