临床误诊误治2018，Vol.31Issue(7)：37-41,5.DOI:10.3969/j.issn.1002-3429.2018.07.010
羟考酮超前镇痛对腹部闭合性损伤患者术后镇痛效果及炎性因子的影响
Effects of Preemptive Analgesia with Oxycodone on Postoperative Analgesia and the Level of Inflammatory Cytokines in Patients with Closed Abdominal Trauma
摘要
Abstract
Objective To observe the effect of preemptive analgesia with oxycodone on postoperative analge-sia and levels of inflammatory cytokines in patients undergoing emergency laparotomy due to closed abdominal trau-ma. Methods A total of 60 cases who underwent emergency laparotomy under general anesthesia after admission to The First Central Hospital of Baoding were randomly divided into observation group and control group, with 30 cases in each group, according to the random number table. Patients in observation group were injected intravenously with 0. 1 mg/kg oxycodone 10 min before induction of anesthesia, and those in control group were given 10 ml 0. 9% sa-line in the meantime. VAS was recorded at different time points, including awaking time immediately after surgery, as well as at 2, 6, 12, and 24 h after surgery. The levels of interleukin-6 (IL-6), interleukin 10 (IL-10) and tumor necrosis factor-α (TNF-α) were measured by ELISA in 10 min before intravenous injection of oxycodone or 0. 9% saline (TI), immediately after surgery (T2), 6 h (T3),12 h (T4), and 24 h (T5) after surgery. Results VAS was significantly lower in observation group immediately after surgery, and at 2, 6 and 12 h after surgery, and there were significant differences ( P<0. 01) . Serum levels of IL-6 at three time points ( T3, T4 and T5) after surgery were significantly higher than those at T1 and T2 ( P<0. 05) , and serum levels of IL-6 in observation group were significantly lower than those in control group ( both P<0. 01) . IL-10 level at T3 and T4 was significantly higher in both groups ( P<0. 05) , and serum IL-10 in observation group was significantly higher than control group ( both P<0. 01) . Serum TNF-α concentration at T4 and T5 was significantly higher in both groups than that at T1 ( P <0. 05). In addition, the level of TNF-α in observation group was significantly lower than that in control group at T4 and T5 (both P<0. 05). Conclusion In patients receiving emergency laparotomy due to closed abdominal trauma, preemptive analgesia with oxycodone can inhibit the release of inflammatory factors, and reduce the central and pe-ripheral nervous system sensitivity, thereby reducing postoperative pain and promoting rehabilitation.关键词
腹部损伤/羟考酮/麻醉和镇痛/炎性因子Key words
Abdominal injuries/Oxycodone/Anesthesia and analgesia/Inflammatory factors分类
医药卫生引用本文复制引用
张金立,肖芳,白艳辉,代志强,于红莲,王硕..羟考酮超前镇痛对腹部闭合性损伤患者术后镇痛效果及炎性因子的影响[J].临床误诊误治,2018,31(7):37-41,5.基金项目
保定市科学技术局科学技术研究与发展计划(17ZF258) （17ZF258）
保定市卫生局基金项目(201703164) （201703164）
