Effects of multimodal analgesia on inflammatory cytokines and rapid rehabilitation after surgery in 3-6 months infant with Hirschprung′s disease
10.3760/cma.j.issn.2095-428X.2019.13.011
- VernacularTitle: 多模式术后镇痛对3～6月龄婴儿巨结肠根治术术后炎性因子及快速康复的影响
- Author:
Jinlian QI
1
;
Yingping JIA
1
;
Xianwei ZHANG
1
;
Wenhua WANG
1
;
Haibing LU
1
;
Zhengchen LI
1
;
Xiuqin YUE
2
Author Information
1. Department of Anesthesiology, Affiliated Children′s Hospital of Zhengzhou University, Henan Children′s Hospital, Zhengzhou Children′s Hospital, Zhengzhou 450018, China
2. Department of Anesthesiology, the First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Ropivacaine;
Inflammatory factor;
Infant;
Rehabilitation
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(13):1011-1015
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effects of patient-controlled intravenous analgesia(PCIA) with Dexmedetomidine, Ropivacaine by local incision infiltration and combined analgesia on inflammatory factors and rapid rehabilitation in infants aged 3-6 months after radical resection of megacolon.
Methods:From June 2016 to March 2018, 90 infants aged 3-6 months underwent radical resection of megacolon in Henan Provincial Children′s Hospital as the subjects.According to the postoperative analgesia mode applied to the children, they were divided into Dexmedetomidine group, Ropivacaine group and combined group (Dexmedetomidine PCIA combined with local infiltration of Ropivacaine), 30 cases in each group.The serum levels of interleukin(IL)-6 and IL-10 were measured and recorded 2 hours before operation and 24 hours after operation, and the analgesic scores of 4, 8, 12 and 24 hours after operation were recorded.The rapid recovery index of each group, standard and the number of complications were compared.
Results:Compared with 2 hours before operation, the serum levels of IL-6 in the Dexmedetomidine group, Ropivacaine group and combined group [(24.61±1.44) ng/L vs.(13.84±0.65) ng/L, (26.39±1.29) ng/L vs.(13.85±0.67) ng/L, (20.58±2.06) ng/L vs.(13.87±0.63) ng/L], IL-10[(27.63±1.52) ng/L vs.(15.79±1.48) ng/L, (28.29±2.34) ng/L vs.(15.41±1.37) ng/L, (23.21±2.71) ng/L vs.(15.47±1.52) ng/L] were significantly higher (all P<0.05), while the levels of IL-6, IL-10 in combined group were lower than those in Dexmedetomidine group and Ropivacaine group (ta=9.172, 9.835; tb=10.221, 11.034, all P<0.05). At 4 h, 8 h, 12 h, 24 h after operation.The analgesic scores in combined group were(1.89±0.23) scores, (1.87±0.15) scores, (1.95±0.17) scores, (2.08±0.18) scores, those of dexmedetomidine group were(2.06±0.24) scores, (2.08±0.18) scores, (2.76±0.29) scores, (2.55±0.31) scores, those of Ropivacaine group were(2.10±0.26) scores, (2.15±0.26) scores, (2.32±0.19) scores, (3.00±0.28) scores, and the analgesic scores in combined group were significantly lower than those in Dexmedetomidine group and Ropivacaine group(ta=8.526, 9.364, 10.287, 9.521; tb=8.729, 9.514, 11.037, 9.184, all P<0.05). In comparison with the first exhaust time, anal extubation time, hospitalization days, hospitalization expenses and antibiotic use time in the three groups, it was found that combined group was significantly better than Dexmedetomidine group and Ropivacaine group(ta=8.315, 8.294, 7.883, 9.261, 10.487; tb=8.582, 8.329, 7.916, 9.348, 10.862, all P<0.05). The incidence of complications in the combined group, Dexmedetomidine group, and Ropivacaine group were not significantly different in 3 groups(χ2=0.577, P=0.749).
Conclusions:The continuous anesthesia of Dexmedetomidine combined with local infiltration of Ropivacaine incision can alleviate the postoperative inflammatory reaction and promote the rapid recovery of children.
