罗比卡因-芬太尼术后镇痛对乳腺癌患者患者白细胞介素-2和白细胞介素-6的影响

Effect of postoperative analgesia with ropivacaine and fentanyl on the levels of IL-2 and IL-6 in patients with breast cancer

目的探讨罗比卡因复合芬太尼行硬膜外自控镇痛(PCEA)对乳腺癌患者术后白细胞介素-2(IL-2)和白细胞介素-6(IL-6)的影响。方法40例乳腺癌根治术患者随机分为两组,每组20例。Ⅰ组为罗比卡因复合芬太尼组;Ⅱ组为罗比卡因复合吗啡组。分别于麻醉前(T0)、术后2h(T1)、24h(T2)、72h(T3)采集外周静脉血,测定T淋巴细胞亚群及IL-2、IL-6水平。结果两组镇痛效果良好,与麻醉前比较,Ⅰ组T淋巴细胞亚群及IL-2水平各时点之间无显著性差异(P>0·05);与Ⅰ组比较,Ⅱ组T1、T2时的CD3+、CD4+、IL-2均明显下降(P<0·05)。结论罗比卡因复合芬太尼行PCEA效果良好,对免疫的抑制作用较轻,适合乳腺癌患者术后镇痛。

Objective To explore the clinical effects of postoperative analgesia with ropivacaine and fentanyl on the levels of IL-2 and IL-6 in patients with breast cancer. Methods Forty patients with breast cancer undergoing breastectomy were divided into two groups. PCEA with 0.125% ropivacaine and fentanyl 0.25 mg was used in group Ⅰ and with 0.125% ropivacaine and morphine 5 mg in group Ⅱ. Peripheral venous blood was taken before anesthesia at 2, 24 and 72 h after operation and the concentration of IL-6, IL-2 and T cell subgroup was measured. Results Postoperative analgesia was satisfied in both groups. Compared with those before anesthesia, there was no significant difference in IL-2 and T cell subgroup after operation in group Ⅰ(P>0.05). CD_3+,CD_4+,IL-2 in group Ⅱ ~2 h, ~24 h after operation were decreased significantly than those in group Ⅰ(P<0.05). ~Conclusions PCEA of 0.125% ropivacaine combined with low dose of fentanyl has little effect on immunofunction and is suitable in patients with breast cancer.