ABSTRACT
OBJECTIVE:To investigate the effects of oxycodone patient-controlled intravenous analgesia (PCIA) on related indicators of patients after laparoscopic radical resection of cervical cancer. METHODS:A total of 120 patients underwent selective laparoscopic radical resection of cervical cancer were selected from our hospital during Feb. 2016-May 2017. They were divided into control group(60 cases)and observation group(60 cases)according to random number table. After laparoscopic radical resection of cervical cancer,control group was given Fentanyl citrate injection 20 μg/kg,added into 0.9% Sodium chloride injection to 150 mL, at 3.5 mL/h with initial dose of 4 mL,PCIA dose of 2 mL and self-control locking time of 10 min. Observation group was given Oxycodone hydrochloride injection 0.4 mg/kg,added into 0.9%Sodium chloride injection to 150 mL,at 3.5 mL/h with initial dose of 4 mL,PCIA dose of 2 mL and self-control locking time of 10 min. VAS scores 12,24,48 h after surgery,serum levels of IFN-γ, IL-10,NK cells,CD3+,CD4+and CD8+30 min before surgery and 24,48,72 h after surgery,the occurrence of ADR were observed in 2 groups. RESULTS:All patients of both groups completed the study. VAS scores of 2 groups 24,48 h after surgery were significantly lower than 12 h after surgery,with statistical significance (P＜0.05). There was no statistical significance between 2 groups(P＞0.05). Thirty min before surgery,there was no statistical significance in the levels of IFN-γ,IL-10,NK cells,CD3+, CD4+or CD8+between 2 groups(P＞0.05);24,48,72 h after surgery,the levels of IFN-γ and IL-10 in 2 groups were significantly higher than 30 min before surgery,and the observation group was lower than the control group,with statistical significance(P＜0.05);the levels of NK cells,CD3+,CD4+and CD8+in 2 groups were significantly lower than 30 min before surgery,but increased gradually as time;the indexes above of observation group was significantly higher than the control group 24,48 h after surgery,with statistical significance(P＜0.05). The incidence of ADR in observation group(8.33%)was significantly lower than control group (20.00%),with statistical significance(P＜0.05). CONCLUSIONS:Oxycodone PCIA shows good analgesic effect after laparoscopic radical resection of cervical cancer and can effectively decrease the levels of serum inflammatory factors and improve immune function with good safety.
ABSTRACT
Objective To investigate the therapeutic effects of intravenous monosialo ganglio-sides(GM-1)on neurotoxicity of intrathecally administered bupivacaine in rats and its possible mecha-nism.Methods One hundred and eight adult male Sprague-Dawley rats,weighing 280-300 g,were randomly divided into 3 groups (n=36 each):sham operation group (group sham),group saline and group GM-1.Neurotoxicity model was performed by injecting 0.12μl/g body weight of bupivacaine at concentrations of 5% via an implanted intrathecal catheter at 90-minute intervals for 4.5 h in groups saline and GM-1.After observing 24 h,group GM-1 was administered GM-1 30 mg/kg by intrave-nous injection for 7 days,once a day;while groups saline and sham received equal volume of normal saline.The recovery of the locomotor function was evaluated with Basso,Beattie and Bresnahan (BBB)and tail-flick latency(TFL)before injection bupivacaine and days 1,3,5,7,14,28 after in-jection,TFL was converted to the percent maximum possible effect (%MPE).Six rats were sacri-ficed in each group at each time point,and spinal cord was taken to examine histological injury scores by light and electron microscopy at the L3 level,and neuron caspase-3 expression was evluated using immunohistochemistry and RT-PCR.Results Compared with group saline,%MPE,histological inju-ry score and caspase-3 mRNA expression were decreased on days 7,14 and 28;Caspase-3 protein ex-pression was decreased on days 5,7,14 and 28;while BBB score was higher on days 14 and 28 in group GM-1 (P < 0.05 ).Compared with group sham,% MPE,histological injury score,caspase-3 mRNA and protein expression in groups GM-1 and saline were significantly higher,while BBB score was lower on 1,3,5,7,14 and 28 d after injection (P <0.05).Conclusion GM-1 can promote neuro-functional recovery after bupivacaine neurotoxicity in rats through the possible mechanism of down-regulating neuron caspase-3 expression.