摘要
目的评价布托啡诺联合芬太尼超前镇痛对结肠癌和直肠癌患者围术期血清IL-6及IL-10水平的影响。方法将2014年11月-2015年11月择期结肠癌、直肠癌手术治疗的患者60例纳入研究,采用计算机随机分组,分为布托啡诺联合芬太尼超前镇痛组(B组)和芬太尼超前镇痛组(C组)。B组患者分别于术前10 min及术毕前30 min静脉给予布托啡诺2.0μg/kg+芬太尼1.5μg/kg;C组患者分别于手术前10 min及术毕前30 min静脉给予芬太尼2.0μg/kg。术前(t_1)、术毕(t2_)、术后6 h(t_3)、术后12 h(t_4)收集右颈内静脉血样本,分别测定血清IL-6和IL-2浓度。测定患者术后2、6、12、24 h的镇痛(VAS)、镇静(Ramsay)评分。同时记录恶心、呕吐、头晕、嗜睡、瘙痒、呼吸抑制等不良反应的发生情况。结果 B组t_2、t_3及t_4时IL-6浓度升高较C组低,C组t3及t4时IL-10抑制较B组更明显。结论布托啡诺联合芬太尼超前镇痛通过下调IL-6和促进IL-10分泌降低机体应激反应和免疫抑制。
Objective To evaluate preemptive analgesia effects on the perioperative serum levels of interleukin- 2and interleukin- 6 in colorectal cancer patients undergoing lower abdominal surgery. Methods Sixty colorectal cancer patients under general anesthesia from November 2014 to November 2015 were randomly allocated into two groups： group B was administered with butorphanol plus fentanyl and group C with fentanyl only. In group B,butorphanol 2. 0 μg / kg ＋ fentanil1. 5 μg / kg were given intravenously 10 min before and 30 min after surgery,while in group C,fentanil 2. 0 μg / kg were given intravenously 10 min before and 30 min after surgery. Right internal jugular venous blood samples were collected before surgery（ t_1）,0 h（ t_2）,6 h（ t_3） and 12 h（ t_4） after surgery to determine the IL- 6 and IL- 10 levels by means of ELISA.VAS. Ramsay scores were measured 2 h,6 h,12 h,and 24 h after surgery. Side effects including vomiting,nausea,dizziness,somnolence,pruritus and respiratory inhibition were also recorded. Results The perioperative IL- 6 levels（ t_2,t_3,t_4） of group B were Lower than those of group C,while the perioperative IL- 10 levels（ t_3,t_4） of group C were significantly decreased compared with those of group B. Conclusion Preemptive analgesia of butorphanol plus fentanyl may reduce body stress response and immune suppression through decreasing IL- 6 levels as well as increasing IL- 10 levels.
出处
《现代医院》
2016年第8期1162-1165,共4页
Modern Hospitals
关键词
布托啡诺
芬太尼
超前镇痛
免疫功能
Butorphanol
Fentanil
Preemptive Analgesia
Immune Function
