Effects of esketamine versus opioid analgesics on postoperative cellular immune function in patients undergoing laparoscopic gynecological surgery / 中华麻醉学杂志
Chinese Journal of Anesthesiology
;
(12): 1321-1325, 2021.
Artigo
em Chinês
| WPRIM
| ID: wpr-933247
ABSTRACT
Objective:
To compare the effects of esketamine and opioids on postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.Methods:
Fifty patients, of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged 20-65 yr, with height 150-180 cm, weighing 50-80 kg, who underwent laparoscopic non-oncologic gynecological surgery with general anesthesia in the Second Hospital of Shanxi Medical University from September 2020 to February 2021, were divided into 2 groups using a random number tablemethod:
esketamine group (group K) and opioid analgesic group (group O), with 25 patients in each group.Anesthesia was induced as follows esmketamine 0.25-0.50 mg/kg was intravenously injected in group K, sufentanil 0.2-0.4 μg/kg was intravenously injected in group O, and propofol 2 mg/kg and rocuronium 0.6-0.9 mg/kg were intravenously injected in two groups.Anesthesia was maintained as follows esketamine was intravenously infused at 0.5 mg·kg -1·h -1 in group K, remifentanil was intravenously infused at 10-20 μg·kg -1·h -1 in group O, and propofol 4-10 mg·kg -1·h -1 was intravenously infused, and rocuronium 0.2-0.3 mg/kg was intermittently injected in two groups.Blood samples from elbow veins were collected before anesthesia induction (T 1) and immediately after extubation (T 2) for determination of T lymphocyte subsets (CD3 + , CD4 + , CD8 + , CD4 + CD25 + CD127 low) and NK cells and B lymphocyte (by flow cytometry) and serum interleukin-6 (IL-6) and IL-10 concentrations (by multiplexed fluorescent microsphere immunoassay). Routine blood tests were performed on preoperative day 1 and postoperative day 3, and neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were calculated.Results:
Compared with group O, the percentages of CD3 + and CD4 + cells, ratio of CD4 + /CD8 + and percentage of NK cells were significantly increased, serum IL-6 concentrations were decreased, and serum IL-10 concentrations were increased after extubation, white blood cell, monocyte and neutrophil counts were increased, and lymphocyte count was decreased on postoperative day 3 ( P<0.05), and no significant change was found in neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in group K ( P>0.05).Conclusion:
Compared with opioid analgesics, esketamine has less inhibition of postoperative cellular immune function in the patients undergoing laparoscopic gynecological surgery.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Idioma:
Chinês
Revista:
Chinese Journal of Anesthesiology
Ano de publicação:
2021
Tipo de documento:
Artigo
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