地佐辛超前镇痛对老年髋关节置换术患者免疫功能的影响

Effect of Dezocine preemptive analgesia on immune function of elderly patients undergoing hip replacement surgery

目的评价地佐辛超前镇痛对老年髋关节置换术患者围术期免疫功能的影响。方法将2 0 1 4 年1 1 月?2 0 1 5 年1 1 月在我院进行髋关节置换术的老年患者6 0 例纳入研究，采用计算机随机分组，分为地佐辛超前镇痛组（A 组）和安慰剂对照组（B 组）。A 组患者分别于术前10 m in 及术毕前30 m in 静脉给予地佐辛0. 2 mg/ k g ; B 组患者分别于手术前10 m in 及术毕前30 m in 静脉给予与A 组同等体积的生理盐水。术前（T 1 ) ，术毕（T2 ) ，术后6 h(T3 ) ，术后12 h ( T4 ) ，术后24 h (T5 ) 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 、1 2、2 4 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 A 组T2 、T3 及T4 时IL - 6 浓度升高较B 组高，A 组T3 及T4 时IL - 1 0 抑制较B 组更明显。结论地佐辛超前镇痛通过下调IL - 6 和促进IL - 1 0 分泌降低机体应激反应和免疫抑制。

Objective Evaluate preemptive analgesia effects of dezocine on the perioperative serum levels of interleukin- 2 and interleukin- 6 in colorectal cancer patients. Methods Sixty patients under general anesthesia were randomly allocated to two group: group A were administered butorphanol plus fentanyl and group B were administered fentanyl only. In group A,dezocine 0. 2 mg / kg were given 10 min before and 30 min after surgery,while in group B,normal saline were given10 min before and 30 min after surgery. Central venous blood were collected before surgery( T1),0h( T2),6h( T3),12h( T4)after surgery to determine the IL- 6 and IL- 10 levels by means of ELISA. VAS and Ramsay scores were measured 2,6,12,and 24 h after surgery. Side effects including vomiting,nausea,and headache were also recorded. Results The perioperative IL- 6 levels( T2、T3、T4) of group A were higher than group B,the perioperative IL- 10 levels( T3、T4) of group B significantly decreased compared with group A. Conclusion Preemptive analgesia of dezocine reduce body stress response and immune suppression through decreasing IL- 10 levels and increasing IL- 6 levels.