Abstract: Objective To investigate the effect of sevoflurane inhalation anesthesia on the recovery and inflammatory response after endoscopic mucosal resection for elderly patients with early esophageal cancer. 
Methods A total of 94 patients with early esophageal cancer who were admitted to the Third People′s Hospital of Suining City for endoscopic mucosal resection were selected and divided into the control group (continuous inhalation of isoflurane to maintain anesthesia, n=47) and the observation group (continuous inhalation of sevoflurane to maintain anesthesia, n=47). The condition during anesthesia recovery was compared between two groups. The levels of inflammatory factors ［interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α)］ at different time points ［before anesthesia (T0), at 2 h after surgery (T1), 6 h after surgery (T2), and 12 h after surgery (T3)］ were compared between two groups. The mini-mental state examination (MMSE) score, the postoperative 40-item Quality of Recovery Scale (QoR-40), and perioperative infection were compared between two groups.
Results Respiratory recovery time ［(6.12±1.28) min vs. (11.46±3.75) min］, tracheal extubation time ［(8.65±2.01) min vs. (17.24±5.68) min］ and orientation recovery time ［(11.26±3.84) min vs. (23.75±6.74) min］ in observation group were shorter than those in the control group (t=9.239, 9.774, 11.038, all P＜0.001). There were significant differences of interactions between groups, time points and timepoints between groups with respect to serum IL-1 and TNF-α levels (P＜0.05). Compared with T0, the serum levels of IL-1 and TNF-α in the two groups were increased at T1, T2 and T3 (P＜0.05), and the serum IL-1 ［(32.75±7.43］ ) ng/L vs. (36.08±8.27) ng/L, (35.28±5.32) ng/L vs. (40.15±8.46) ng/L, (40.31±6.08) ng/L vs. (45.74±7.53) ng/L］, and TNF-α ［(34.26±8.84) ng/L vs. (39.86±9.02) ng/L, (33.28±8.69) ng/L vs. (48.42±9.13) ng/L, (43.75±9.46) ng/L vs. (58.15±9.83) ng/L］  at T1, T2 and T3 in the observation group was lower than those in the control group (P＜0.05). The QoR-40 score ［(182.21±9.84) points vs. (175.68±8.43) points］ and MMSE score ［(28.84±5.13) points vs. (26.16±5.03) points］ in the observation group at 3 d after operation were higher (t=3.455, 2.577, P=0.001, 0.012),and the incidence of delirium (2.13%) was lower than that of the control group (17.02%, P=0.014). The overall incidence of infection in the two groups (12.77% vs. 17.02%) was similar (χ2=0.336, P=0.562). 
Conclusion Sevoflurane inhalation anesthesia is effective in endoscopic mucosal resection of elderly patients with early esophageal cancer, which can reduce the incidence of delirium and improve cognitive function. 

Key words: stomach neoplasms, sevoflurane, endoscopic mucosal resection