地佐辛术后静脉镇痛对髋关节置换术患者血浆白三烯B4 5-羟色胺及去甲肾上腺素的影响

Effects of postoperative intravenous analgesia with dezocine on plasma leukotriene B4( LTB4),5-hydroxytryptamine( 5-HT ) and norepinephrine( NE) in hip replacement patients

目的：观察地佐辛术后静脉镇痛对髋关节置换术患者血浆白三烯B4（LTB4）、5-羟色胺（5-HT）和去甲肾上腺素（ NE）的影响。方法择期全麻下髋关节置换术患者60例随机均分为地佐辛组（ D组）、吗啡组（ M组）和对照组（ N组）。 D组：地佐辛0．8 mg/kg加0．9％氯化钠注射液稀释到100 mL，给药速率为2 mL/h持续泵入，负荷剂量为0．15 mg/kg；M组：吗啡0．5 mg/kg加0．9％氯化钠注射液稀释到100 mL，给药速率2 mL/h持续泵入，负荷剂量为0．05 mg/kg；N组：在患者需要时给予肌注吗啡10 mg。分别于麻醉诱导前（ T0）、术后12小时（ T1）、24小时（ T2）、36小时（ T3）及48小时（ T4）采集肘静脉血3 mL，采用酶联免疫吸附测定法（ ELISA）测定血浆LTB4、5-HT和NE的浓度。观察并记录T1、T2、T3及T4视觉模拟评分（ VAS）得分。结果 D组和M组T1～T4时LTB4、5-HT和NE明显低于N组（P＜0．05）；D、M组T1、T2时VAS评分明显低于N组。结论地佐辛与吗啡一样，术后静脉镇痛能抑制LTB4、5-HT和NE的升高。

Objective To investigate the effects of postoperative intravenous analgesia with dezocine on plasma leukotriene B 4 （LTB4）,5-hydroxytryptamine （5-HT ）and norepinephrine（NE）in hip replacement patients.Methods Patients underwent general anesthe-sia for elective hip replacement were equally randomized into three groups：group D received dezocine 0.8 mg/kg dissolved in 100 ml 0.9%sodium chloride injection with load quantity of 0.15 mg/kg,group M was administered morphine 0.5 mg/kg dissolved in 100 ml normal saline with load amount of 0.0 5mg/kg,and group N was given morphine injection intramuscular when needed .Disposable continuous analgesic pump was employed for each patient in group D and M with injection rate of 2 ml/h.Venous blood samples（3 ml）were taken from elbow vein. Plasma LTB4,5-HT and NE concentrations were measured before anesthesia induction （T0）and 12 h（T1）,24 h（T2）,35 h（T3）,48 h（T4）af-ter surgery by ELISA.Visual analogue scale（VAS） was recorded at 12 h（T1）,24 h（T2）,35 h（T3）,48 h（T4）after surgical procedure.Re-sults Compared to N group,plasma levels of LTB4,5-HT and NE were significantly lower in group D and M at T 1 to T4（P〈0.05）.VAS was significantly lower in group D and M at T1 to T2（P〈0.05）.Conclusion Dezocine,comparable to morphine,may inhibit the elevation of LTB4,5-HT and NE in plasma during postoperative intravenous analgesia .