ABSTRACT
Objective The purpose of this study was to investigate the preventive effect of flurbiprofen axetil or small-dose ketamine for remifentanil-induced postoperative hyperalgesia. Methods 120 anesthetized patients with ASA ⅠorⅡwere randomly divided into three groups. Group A (40 cases) was given 0.5 mg/kg of ketamine by intravenous injection,and 5μg/(kg.min) vein to maintain,group B (40 cases) was given 100 mg of preoperative flurbiprofen axetil by intravenous injection and group C (40 cases) had no flurbiprofen axetil or ketamine which was served as controls. After the treatment, all groups were given continuous intravenous tramadol controlled analgesia (PCIA) . Results After 1 h, 2 h, 4 h and 8 h, the visual analog scale (VAS) of group C was significantly higher than that of group A and group B ( 0.05) . The number of fentanyl analgesia were 25 cases and postoperative 24 h PCIA self-control were (8.6 ±4.2) times, which were more than 7 cases and (3.3 ±2.8) times of group A, and 6 cases and (3.2 ± 2.2) times of group B ( <0.05) . Conclusion The preoperative administration of flurbiprofen axetil or intraoperative continuously administered ketamine is able to prevent the occurrence of remifentanil-induced postoperative hyperalgesia, and it will not affect the patient regained consciousness. The method is safe and reliable,so it is worth promoting and popularizing.
ABSTRACT
Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P ＜ 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P ＜ 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.