脊麻加微量吗啡对剖宫产患者细胞因子的影响

Effects of morphine added into spinal anesthetic solution on cytokines in patients undergoing cesarean section

目的探讨脊麻加微量吗啡对剖宫产患者细胞因子的影响。方法30例择期剖宫产患者随机分成两组:Ⅰ组(20例),脊麻用药0.75%布比卡因1.8ml加吗啡0.2mg;Ⅱ组(10例),脊麻用药0.75%布比卡因1.8ml。分别于麻醉前(T0)、术后即时(T1)、24h(T2)、72h(T3)采集外周静脉血测定白细胞介素(IL)-6、IL-8、IL-10和肿瘤坏死因子α(TNF-α)。结果与T0相比,Ⅰ组T1时IL-6[(0.17±0.01)vs.(0.19±0.01)ng/ml]和IL-10[(30.91±5.86)vs.(36.48±7.63)ng/ml]均明显下降(P<0.05和P<0.01),Ⅱ组T1时IL-6明显下降(P<0.05)。T3时Ⅰ组IL-10显著低于Ⅱ组[(33.40±2.23)vs.(29.25±7.65)ng/ml](P<0.05)。两组患者TNF-α相比差异无统计学意义。结论脊麻加微量吗啡对剖宫产患者的细胞因子有轻度影响。

Objective To investigate the effects of morphine added into spinal anesthetic solution on cytokines in patients undergoing cesarean section. Methods Thirty patients undergoing selective cesarean section were allocated randomly into two groups of Ⅰ （n=20） （0.75 % bupivacaine 1.8 ml＋morphine 0.2 mg） and Ⅱ （n=10） （0.75% bupivacaine 1.8 ml）. Interleukin （IL）-6,IL-8,IL- 10 and tumor necrosis factor-α（TNF-α in peripheral venous blood were detected before anethesia （T0） ,at completion of surgery （T1）,24 h （T2） and 72 h （T3） after operation. Results Compared with To ,IL-6 and IL-10 were significantly decreased at T1[（0.17±0. 01） vs. （0.19±0.01） ng/ml and （30.91±5.86） vs. （36.48±7.63） ng/ml] （P〈0.05 and P〈0.01） in group Ⅰ ,and IL-6 was decreaed at T1 in group 1] （P〈0.05）. IL-10 was lower in group Ⅰ than that in groupⅡ at T3[（33.40±2.23） vs. （29.25 ±7.65） ng/ml ] （P〈0.05）. Conclusion Small dose of morphine added into spinal anesthetic solution has a slight effect on cytokines in patients undergoing cesarean section.