Effects of different postoperative analgesia on the postoperative stress and immunity function in patients undergoing total hysterectomy
10.3760/cma.j.issn.1673-4904.2013.06.003
- VernacularTitle:不同术后镇痛方式对子宫全切术患者术后应激反应与免疫功能的影响
- Author:
Gang CHEN
- Publication Type:Journal Article
- Keywords:
Analgesia;
T-lymphocyte subsets;
Stress
- From:
Chinese Journal of Postgraduates of Medicine
2013;(6):6-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effects of different postoperative analgesia on the postoperative stress and cellular immune function in patients undergoing total hysterectomy.Methods Seventy-five patients undergoing total hysterectomy were divided into three groups by table of random digit with 25 cases each:morphine patient controlled epidural analgesia (PCEA) group (group A),tramadol PCEA group (group B) and butorphanol tartrate preemptive analgesia combined with tramadol PCEA group (group C).Peripheral venous blood samples were taken before anesthesia,the end of operation,1 and 3 d after operation for the serum levels of cortisol,norepinephrine (NE),epinephrine (E) and T-lymphocyte subsets (CD4+,CD8+).Results The serum levels of cortisol at the end of operation and 1,3 d after operation in group A and B had significant difference compared with those before anesthesia (P ＜ 0.05),the serum level of cortisol at 1d after operation in group C had significant difference compared with that before anesthesia (P ＜ 0.05).Compared with those before anesthesia,in the 3 groups,there were significant differences in the serum levels of E at the end of operation and 1 d after operation and the serum levels of NE at the end of operation and 1,3 d after operation (P ＜0.05).Compared with the same time of group A and B,there were significant differences in the serum levels of cortisol and E at 1 d after operation and the serum levels of NE at 1,3 d after operation in group C (P ＜ 0.05).CD4+,CD4+/CD8+ at the end of operation and 1,3 d after operation in 3 groups were significantly lower than those before anesthesia (group A:0.266 ±0.034,0.226 ±0.029,0.256 ±0.031 vs.0.313 ±0.030 and 1.3 ±0.3,1.0 ±0.1,1.1 ±0.2 vs.1.5 ±0.2,group B:0.271 ±0.031,0.242 ± 0.027,0.261 ± 0.030 vs.0.311 ± 0.034 and 1.3 ± 0.2,1.1 ± 0.1,1.2 ± 0.1 vs.1.5 ± 0.1,group C:0.282 ±0.036,0.276 ±0.030,0.290 ±0.028 vs.0.314 ±0.032 and 1.4 ±0.2,1.3 ±0.1,1.4 ±0.1 vs.1.5 ± 0.2,P ＜ 0.05).There were significant difference in CD4+ and CD4+/CD8+ 1,3 d after operation of group C than those of group A and B (P＜ 0.05).There was no significant difference in CD8+ among the 3 groups (P＞0.05).Conclusion Butorphanol tartrate preemptive analgesia combined with tramadol PCEA may reduce postoperative stress response and immune depress,compared with only morphine or tramadol PCEA.
