吗啡和曲马多用于妇科术后镇痛对白细胞介素-2的影响

目的 比较吗啡和曲马多妇科术后自控静脉镇痛(PCIA)时对血清白细胞介素-2(IL-2)分泌的影响。方法 全麻下行妇科腹腔镜手术60例,按照术后镇痛用药随机分成吗啡组(M组)和曲马多组(T组)。分别于麻醉前、术后1 h、术后3 h、术后24 h采血,应用放免法检测血清IL-2。结果 与麻醉前相比,M组术后各时点血清IL-2水平明显降低(P<0.05或P<0.01),T组术后1 h与麻醉前比较无显著性差异(P>0.05),术后3 h明显升高(P<0.05),术后24 h达到更高水平(P<0.01)。结论 二者均可减轻术后疼痛,与吗啡抑制IL-2分泌相反,曲马多可明显提高妇科腹腔镜手术患者术后IL-2的分泌。

Effect of morphine and tramadol on IL-2 in gynecologic postoperative analgesia

Objective To compare the effect of morphine and tramadol on the production of IL-2 during patient-controlled intravenous analgesia (PCIA) in postoperative gynecologic patients. Methods Sixty gynecologic patients undergoing laparoscopic surgery were randomized to two groups according to postoperative analgs sics: morphine group (group M) and tramadol group (group T). Peripheral venous blood was drawn before anesthesia induction and 1 h, 3 h, 24 h after operation. Serum IL-2 levels were determined by radioimmunoassay. The VAS, consumption of analgesics, purges of PCA and the incidences of side effects were recorded. Results No significant difference was observed between the two groups in VAS score, purges of PCA and postoperative complications (P>0.05). In group M, the production of IL-2 was decreased significantly at all time points after operation as compared with preoperation level (P<0.05 or P<0.01). In group T, the production of IL-2 was not changed obviously 1 h after operation (P>0.05). Whereas the level of IL-2 was increased from postoperative 3 h (P<0.05) and became even higher at postoperative 24 h (P<0.01). Conclusion Both morphine and tramadol could alleviate the postoperative pain. In contrast to the suppression of morphine of IL-2, tramadol could increase the level of IL-2 in post-laparoscopic patients.