Objective To investigate the effects of different anesthesia depths on stress states and inflammatory mediators in patients undergoing video-assisted thoracoscopic lobectomy.

Methods A total of 89 lung cancer patients who underwent video-assisted thoracoscopic lobectomy were selected as study subjects. Based on intraoperative bispectral index (BIS) range, the patients were divided into deep anesthesia group (BIS of 40 to < 50, n=45) and shallow anesthesia group (BIS of 50 to < 60, n=44). Vital signs (mean arterial pressure, heart rate and blood oxygen saturation), anesthesia recovery time, extubation time, dosage of vasoactive drugs, postoperative pain intensityVisual Analogue Scale (VAS), postoperative analgesic dosage, perioperative stress stateprostaglandin E2 (PGE2), nerve growth factor (NGF) and substance P (SP), levels of inflammatory mediatorsneuron-specific enolase (NSE), tumor necrosis factor-α (TNF-α) and S100β protein at different time points (before anesthesia induction, immediately after intubation, before lesion resection and at the end of surgery) and the incidence of anesthesia-related adverse reactions were compared between the two groups.

Results Before lesion resection and at the end of surgery, the mean arterial pressure and heart rate in the deep anesthesia group were significantly lower than those in the shallow anesthesia group (P < 0.05). The anesthesia recovery time and extubation time in the deep anesthesia group were significantly longer than those in the shallow anesthesia group (P < 0.05). At the end of surgery and on postoperative day one, the levels of PGE2, NGF and SP in the deep anesthesia group were significantly lower than those in the shallow anesthesia group, while the levels f NSE, TNF-α and S100β protein were significantly higher than those in the shallow anesthesia group (P < 0.05). There were no significant differences in the dosage of vasoactive drugs, VAS scores, sufentanil dosage and the incidence of anesthesia-related adverse reactions between thetwo groups (P>0.05).

Conclusion During one-lung ventilation in patients undergoing video-assisted thoracoscopic surgery lobectomy, deep anesthesia can effectively control surgical stress and maintain stability of intraoperative hemodynamics, but it is associated with delayed postoperative awakening and more pronounced inflammatory response. Shallow anesthesia results in faster postoperative awakening and lower levels of inflammatory mediators, but it is associated with more significant intraoperative stress response and unstable hemodynamics.