Effect of Different Doses of Oxycodone on Plasma Thromboxane A2, Plasma Endothelin Levels and Immune Function of Patients Underwent Laparoscopic Cholecystectomy / 现代生物医学进展

ABSTRACT

Objective:To study the effect of different doses of oxycodone on the serum thromboxane A2 (TXA2),plasma endothelin (ET) levels and immune function of patients underwent laparoscopic cholecystectomy.Methods:90 patients of elective laparoscopic cholecystectomy who were treated from August 2013 to August 2016 in our hospital were selected and divided into 3 groups by random number table,with 30 cases in each group.At the beginning of operation,they were given intravenous oxycodone,group A was given 0.1 mg/kg oxycodone,group B was given 0.2 mg/kg oxycodone,group C was given 0.3 mg/kg oxycodone.The changes of hemodynamics,serum TXA2 and ET levels were compared between the three groups at T0 (after admission),T1 (after anesthesia induction),T2 (after intubation),T3 (gallbladder separation),T4 (end of surgery) and the changes of immune function was compared at T0,T5 (postoperative 2h),T6(postoperative 1d),T7 (postoperative 3d);and the extubation time,recovery time,hypotensor,additional analgesics situationin and adverse reactions were recorded.Results:The diastolic pressure (DBP),systolic blood pressure (SBP),heart rate (HR) in three groups at T2,T3 point was significantly higher than T0 point(P＜0.05),the DBP,SBP and HR in the B,C groups were significantly lower than the A group at T2 and T3 point(P＜0.05);the TXA2 in three groups at T2,T3,T4 point was significantly higher than T0 point(P＜0.05),and A group＞B group＞C group,there was significant difference between the two groups (P＜0.05);the ET in three groups at T2,T3 point was significantly higher than T0 point(P＜0.05),the ET in the B,C group was significantly higher than the A group at T2,T3 point(P＜ 0.05);the CD3+,CD4+,CD8+ and CD4+/CD8+ of the three groups at T5 point were significantly lower than that ofT0 point (P＜0.05),the CD3+,CD4+,CD8+ and CD4+/CD8+ in A group were significantly lower than that of B,C group at T5 point (P＜0.05);the extubation time in C group was significantly longer than that of A,B group(P＜0.05);the total incidence of adverse reactions in C group was significantly higher than that the A,B group (P＜0.05).Conclusion:In the laparoscopic cholecystectomy,application of 0.2 mg/kg oxycodone had little effect on hemodynamics,serum TXA2,ET levels and immune function with higher safety.