Effect of three kinds of anaesthetic drugs on postoperative recovery, regulatory T cells and T lymphoid cells in elderly patients

Purpose: To investigate the effect of three anaesthetic drugs on postoperative recovery, regulatory T cells and T cell subset levels in elderly patients. Methods: The patients were randomly divided into groups A, B and C (42 patients per group). Group A received intravenous remifentanil, dexamethasone, dexmedetomidine and propofol, followed by continuous intraoperative inhalation of sevoflurane and continuous intravenous pumping of remifentanil. Group B was given intravenous propofol and midazolam, followed by continuous intraoperative inhalation of sevoflurane, while Group C received intravenous etomidate and rocuronium, with continuous intraoperative inhalation of sevoflurane. The preoperative or 24-h postoperative T regulatory cells (CD4(+) CD25(+)) and T cell subsets (CD4(+) and CD8(+)) were determined for each group. Results: MMSE scores in the three groups were lower than their pre-operation scores (p < 0.05). There were significant reductions in 24-h postoperative serum CD4(+) CD25(+) and CD4(+) levels, with higher reductions in group B (p < 0.05). In contrast, CD8(+) increased in all groups, but was lower in group B than in the other two groups (p < 0.05). Conclusion: These findings strongly suggest that propofol, midazolam and sevoflurane have rapid onset of action and recovery, which improves the comfort of patients while decreasing negative impact on the function of the immune system. Furthermore, these anaesthetic agents enhance the recovery of elderly patients.