To investigate the effect of remifentanil combined with epidural anesthesia in radical gastrectomy for gastric cancer and its effect on hemodynamics.

A total of 100 patients undergoing radical gastrectomy D2 in Hainan Western Central Hospital from January 2018 to December 2019 were selected as study subjects. They were divided into two groups according to different anesthesia methods: the combination group was given remifentanil combined with epidural anesthesia, while the control group was given general anesthesia only. The operative indicators, hemodynamic indicators, stress response indicators, Steward recovery score before ventricle, pain score 24 h after surgery and complications were compared between the two groups.

The dosage of propofol and remifentanil in the combination group was less than that in the control group, and the extubation time and wake time was better than those in the control group (P<0.05). There were no statistically significant differences in operative time, intraoperative blood loss, intraoperative infusion volume, and cerebral state index (CSI) at each time point between the two groups. There were no statistically significant differences in HR, MAP, SBP and DBP between the two groups before anesthesia. HR, MAP, SBP and DBP in the combination group were significantly lower than those in the control group at 60 min after anesthesia and 10 min after extubation (P<0.05). At 3 d and 7 d postoperatively, the levels of Cor, Ne and TAC in the combination group were significantly lower than those in the control group (P<0.05). Steward recovery score and VAS score 24 h after surgery in the combination group were better than those in the control group (P<0.05).

The application of remifentanil combined with epidural anesthesia in radical gastrectomy for gastric cancer patients can promote patients’ recovery, maintain the intraoperative hemodynamic stability, reduce stress response, and relieve postoperative pain. It is safe and feasible, and can be promoted in clinical practice.