Effects of laparoscopic cholecystectomy under different anesthetic methods on T-lymphocyte immune function and postoperative analgesia / 中国针灸

ABSTRACT

<p><b>OBJECTIVE</b>To compare the differences in the effect of laparoscopic cholecystectomy (LC) with different anesthetic methods on T-lymphocyte immune function and postoperative analgesia as well as validate the specificity of meridian points.</p><p><b>METHODS</b>Ninety cases of LC were randomized into three groups, named group A (compound general anesthesia group with meridian points involved), group B (compound general anesthesia group with placebo points involved) and group C (general anesthesia group). In group A, electroacupuncture was applied at first for 15 to 30 min to bilateral Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36), Yanglingquan (GB 34) and Quchi (LI 11). Afterwards, the general anesthesia was conducted and electric stimulation lasted till the end of operation. In group B, the points adopted were the midpoints between the meridians in which the acupoints were selected in group A and the adjacent meridians on the lateral side, at the level of selected meridian points correspondingly. The method and time of electroacupuncture were same as those in group A. In group C, the general anesthesia was adopted simply. The changes of T-lymphocyte subgroup were detected before anesthesia, in 2 h, 1 day and 3 days after operation separately; and the dose of narcotic in operation as well as the dose of analgesia pumper in 4 h, 6 h, 8 h, 24 h and 44 h after operation separately.</p><p><b>RESULTS</b>(1) In comparison between the result 2 h after operation and that before operation, the levels of CD3+, CD4+ and CD8+ in all of three groups were lower than those before operation. Except that the change in CD4+ in group A did not present significant statistical difference as compared with that before operation (P > 0.05), all of the other differences in T-lymphocyte subgroup indicated statistical significance (all P < 0.05). The ratio of CD4+/CD8+ in three groups was higher than that before operation, but the difference in group A was significant statistically (P < 0.05). In 3 days after operation, the levels of CD3+, CD4+ and CD4+/CD8+ were all higher than those before operation, indicating significant statistical differences (all P < 0.05) except CD4+/CD8+ in group B (P > 0.05). (2) In group A, during operation, the dose of narcotic reduced apparently (P < 0.05). (3) Separately, in 4, 6 and 8 h after operation, the dose of analgesia pumper reduced significantly in group A (all P < 0.05).</p><p><b>CONCLUSION</b>Compound general anesthesia with meridian points involved can increase pain threshold of human body, reduce the dose of narcotic during operation, alleviate the suppression in body immune regulation due to stress reaction of general anesthesia and operation, prolong the time-effect of postoperative analgesia and explain the specificity of meridian points.</p>