不同配伍布比卡因用于小儿硬膜外术后镇痛对呼吸和sIL2-R、IL-6的影响

目的 :比较不同配伍布比卡因用于小儿术后硬膜外镇痛对呼吸功能和sIL 2R、IL 6的影响。方法 :6 0例连续硬膜外麻醉手术患儿 ,随机分为 3组 ,每组 2 0例。术后 3组分别经硬膜外导管以 2ml/h速度输注 0 .12 5 %布比卡因 6 0ml(B)、0 .12 5 %布比卡因 6 0ml(内含吗啡 15 0 μg/kg) (BM)、0 .12 5 %布比卡因 6 0ml(内含芬太尼 10 μg/kg)(BF)。间断检测患儿潮气量 (VT)、呼吸频率 (RR)和每分通气量 (VE) ;用ELISA法动态测定患儿血中可溶性白介素2受体 (sIL 2R)和白介素 6 (IL 6 )浓度。结果 :①B组VT 术后 1h明显下降并低于BM和BF组 ,至术后 2 4h仍未恢复到术前水平 ,②术后血中sIL 2R浓度在各组中均明显增加 ,在B组其浓度持续升高 ;血IL 6水平B组在术后 8h明显高于BM和BF组。结论 :内含小剂量吗啡或芬太尼的 0 .12 5 %布比卡因用于患儿术后硬膜外镇痛 ,能改善患儿术后的呼吸功能 ,减轻免疫抑制

Effects of Different Couples of Bupivacain on sIL-2R,IL-6 and Respiratory Function for Postoperation Epidural Analgesia in Children

Objective:To compare the effects of different couples of Bupivacine used for PEA on respiratory function and serum levels of sIL 2R and IL 6. Methods: Sixty children undergoing operations were randomly divided into three groups,and different drugs were given to induce analgesia. The children's tidal volume, respiratory rate and Minute Volume at different time were tested. By ELISA method the serum level of sIL 2R and IL 6 were tested. Results: (1) V T in group B could not reverse till 24 hours.(2)Serum sIL 2R level kept increasing in group B. Serum IL 6 level at 8 hours postopration in group B were higher than that of group BM and BF. Conclusion: 0.125% bupivacain with mophine or fentanyle can improve the patients, respiratiory function after operation,and lessen immunity depression.