Abstract

This study aimed to investigate the effect of perioperative injection of lidocaine and nursing intervention on the immune functions of patients receiving radical resection for colorectal cancer and to shed new light on the selection of anesthetic regimens for perioperative patients. Fifty-eight patients receiving laparoscopic radical resection for colorectal cancer were recruited, and randomly divided into control group and experiment group, with 29 patients in each group. Patients in the control group received conventional perioperative nursing, and those in the experimental group accepted comprehensive perioperative nursing. For the experimental group, lidocaine was intravenously injected for about 10 min at 15 min before general anesthesia. Orotracheal intubation was performed under the optical laryngoscope for general intravenous anesthesia. Lidocaine was constantly pumped during the operation, until the skin suture was over. The control group received intravenous injection of an equal volume of normal saline instead of lidocaine. At 24 h before surgery, 0 h after surgery and 24 h after surgery, 10.0 ml of peripheral blood was collected from each subject, respectively, and added with ethylenediaminetetraacetic acid. The samples were sent for determination by flow cytometry within 24 h. Time-to-ambulation, time-to-eat, length of hospital stay and incidence of complications were recorded for the two groups. Compared with 24 h before surgery (T0), the percentages of lymphocytes per total peripheral white blood cells decreased at 0 h after surgery (T1) and at 24 h after surgery (T2) for the two groups (p<0.05). The ratios of T-lymphocytes to total lymphocytes, ratios of helper T cells to T-lymphocytes and CD4+/CD8+ ratios first increased and then decreased for the two groups (p>0.05). The percentages of NK cells to lymphocytes first decreased and then increased (p>0.05). The percentage of Treg cells to T-lymphocytes at T1 and T2 for the control group first decreased and then increased (p>0.05). Compared with the control group, percent lymphocytes in the experimental group decreased less dramatically. Percent helper T cells to T-lymphocytes and CD4+/CD8+ ratio increased more faster at T1 and decreased at a lower rate at T2. The percentage of cytotoxic lymphocytes (CTLs) to T-lymphocytes at T1 decreased faster and increased slowly at T2 (p>0.05). The percentage of Treg cells to T-lymphocytes decreased at both T1 (p<0.05) and T2 (p>0.05). The percentage of NK cells to lymphocytes decreased slowly at T1 and increased faster at T2 (P>0.05). Time-to-ambulation time-to-eat and length of hospital stay were all shorter in the experimental group than in the control group (p<0.05). The incidence of complications in the experimental group was significantly lower than that of the control group (p<0.05). In conclusion, lidocaine improved the inhibitory effect on the T-cell-mediated immune response during perioperative period, blocking the proliferation of Treg cells. However, it had no apparent impact on the proliferative ability of NK cells during the perioperative period. Nursing intervention facilitated patients’ recovery and lowered the incidence of complications.