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Analgesic effect of different doses of dexmedetomidine combined with ropivacaine on continuous transverse abdominal plane block and its influence on immune function / 中国医师进修杂志
Chinese Journal of Postgraduates of Medicine ; (36): 418-421, 2019.
Article in Chinese | WPRIM | ID: wpr-753283
ABSTRACT
Objective To investigate the effects of different doses of dexmedetomidine (Dex) combined with ropivacaine continuous transverse abdominal plane (TAP) block on analgesia and immune function in patients with laparoscopic colon cancer surgery. Methods Fifty colon cancer patients who had underwent laparoscopic radical resection from January 2017 to May 2018 in Wenzhou People′s Hospital were selected. The patients were divided into group A and group B according to random digits table method with 25 cases each. Group A was treated with 0.75 μg/kg Dex before operation; group B was treated with 1.00 μg/kg Dex before operation, then 2.00 μg/kg Dex continuous analgesia 48 h after operation. Both groups were given 0.375% ropivacaine 40 ml before operation for TAP block, and 0.2% ropivacaine 5 ml/h continuous analgesia 48 h after operation. The visual analogue score (VAS), interferon γ (IFN-γ), interleukin 10 (IL-10), T lymphocyte subsets (CD4+and CD8+) 12, 24 and 48 h after operation and adverse reactions were observed. Results The VAS 12, 24 and 48 h after operation in group B was significantly lower than that in group A (2.2 ± 0.6) scores vs. (3.1 ± 0.9) scores, (1.6 ± 0.4) scores vs. (2.3 ± 0.8) scores and (1.1 ± 0.3) scores vs. (1.9 ± 0.6) scores, and there was statistical difference (P<0.05). The IFN-γ and CD4+12, 24 and 48 h after operation in group B were significantly higher than those in group A, IFN-γ (281.6 ± 42.1) ng/L vs. (213.5 ± 37.4) ng/L, (335.7 ± 42.5) ng/L vs. (244.2 ± 36.3) ng/L and (362.4 ± 42.8) ng/L vs. (258.6 ± 36.8) ng/L; CD4 + 0.186 ± 0.047 vs. 0.163 ± 0.045, 0.265 ± 0.058 vs. 0.215 ± 0.052 and 0.314 ± 0.062 vs. 0.226 ± 0.053. The IL-10 and CD8+were significantly lower than those in group A, IL-10 (263.5 ± 28.7) ng/L vs. (314.2 ± 35.6) ng/L, (225.4 ± 26.9) ng/L vs. (279.5 ± 29.8) ng/L and (206.3 ± 26.1) ng/L vs. (272.1 ± 29.2) ng/L; CD8 +0.268 ± 0.062 vs. 0.295 ± 0.064, 0.217 ± 0.048 vs. 0.266 ± 0.061 and 0.164 ± 0.036 vs. 0.243 ± 0.055. There were statistical differences (P<0.05). There was no statistical difference in the incidence of adverse reactions between 2 groups (P>0.05). Conclusions Different doses of Dex combined with ropivacaine continuous TAP block has good analgesic effect on colon cancer patients who had underwent laparoscopic radical resection. However, high first dose load and continuous combination is better and has less effect on immune function.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Postgraduates of Medicine Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Postgraduates of Medicine Year: 2019 Type: Article