Influence of Anesthetic Technique on the Postoperative Biological Stress Response in Thyroid Cancer Patients Receiving Psychological Intervention During Ultrasound-Guided Thyroidectomy.

Abstract

Objective: To examine the influence of various anesthetic techniques on the postoperative biological stress response in thyroid cancer (TC) patients receiving psychological nursing intervention during ultrasound-guided radical thyroidectomy. Methods: TC patients undergoing ultrasound-guided radical thyroidectomy at The Third Affiliated Hospital of Southern Medical University between January 2020 and June 2022 were enrolled and randomly assigned to two groups based on anesthetic protocol. Both groups received general anesthesia and standardized psychological nursing intervention. Intervention group received remifentanil-propofol anesthesia, whereas reference group received sevoflurane-propofol anesthesia. Hemodynamic parameters, serum stress biomarkers (cortisol [Cor], norepinephrine [NE], glucose [Glu]), inflammatory cytokines (interleukin-1β, tumor necrosis factor-alpha, interleukin-10), pain intensity (visual analog scale [VAS] scores), recovery metrics, adverse events, and psychological outcomes were evaluated and compared. Results: The intervention group showed significantly shorter response recovery time, eye-opening time, spontaneous respiration recovery time, and extubation time than reference group (p < 0.05). Postoperative VAS scores decreased in both groups from 0.5 to 12 h, with the intervention group reporting consistently lower scores at all time points (p < 0.05). Hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure) and serum stress biomarkers (Cor, NE, Glu) were significantly lower in intervention group during key intraoperative periods (T1, T2, T3) (p < 0.05). Inflammatory cytokine levels rose intraoperatively in both groups, but were markedly lower in intervention group at T3, T4, and T5 (p < 0.05). The adverse reactions' incidence was also lower in intervention group (χ² = 4.523, p < 0.05). Both groups showed improved psychological status, comfort, and illness perception postintervention, with nursing satisfaction exceeding 90%. Conclusions: Remifentanil-propofol anesthesia, when combined with psychological intervention, provides superior control over the biological stress response, enhances analgesia, and promotes faster recovery compared with sevoflurane-propofol anesthesia in TC patients undergoing ultrasound-guided thyroidectomy. This approach is clinically beneficial and warrants broader application.