Evidence map›Paper›PMID 39097834›Full record

ReviewBiomolecules & biomedicine2025

Effects of spinal-epidural anesthesia combined with intravenous etomidate on adrenocortical and immune stress in elderly patients undergoing anorectal surgery: A retrospective analysis.

Yangyi Li, Jiangyan Wu, Chengbo Chen, Changsheng Su

Abstract readReview
In one paragraph

Review in Biomolecules & biomedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review of the Effects of Anesthetic Techniques and Medications on the Immune Response During the Perioperative Period.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Yangyi LiDepartment of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China.
Jiangyan WuDepartment of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China.
Chengbo ChenDepartment of Cardiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China.
Changsheng SuDepartment of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The management of anesthesia in elderly patients undergoing surgery presents unique challenges, particularly in mitigating stress responses and ensuring stability. Etomidate may alleviate adrenocortical and immune stress. This study aims to investigate the anesthetic effects of combined spinal-epidural anesthesia (CSEA) supplemented with etomidate during anorectal surgery in elderly patients. The medical records of 49 cases treated with CSEA and etomidate (ETO group) and 48 cases treated with CSEA alone (control group) were reviewed and analyzed. All patients received ropivacaine hydrochloride for anesthesia, with the ETO group additionally receiving an infusion of etomidate for sedation. Parameters such as arterial blood gas, visual analog scale (VAS), Ramsay sedation scale (RSS), serum cortisol and norepinephrine levels, pro-inflammatory cytokines, and lymphocyte ratios were assessed at different time points. Compared to the control group, the ETO group showed increased mean arterial pressure, decreased heart rate, and elevated arterial SpO2 30 minutes after anesthesia. The ETO group also had higher RSS scores, lower VAS scores, and reduced serum cortisol and norepinephrine levels. Additionally, decreased levels of pro-inflammatory cytokines, such as interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-8, were observed, along with an increase in the regulatory cytokine IL-10. An increased proportion of CD4+ T cells and a higher CD4/CD8 ratio were also noted. This study demonstrates the benefits of using etomidate to mitigate adrenocortical and immune stress in elderly patients undergoing anorectal surgery.

Indexed as

Adrenal CortexAnal CanalAnesthesia, EpiduralAnesthesia, SpinalEtomidateRectumStress, PhysiologicalAgedAged, 80 and overAnesthetics, IntravenousCytokinesFemaleHumansHydrocortisoneMaleNorepinephrineAnesthetics, IntravenousCytokinesEtomidateHydrocortisoneNorepinephrine

Identifiers

PMID39097834
PMCPMC12010978

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.