围术期镇痛对术后炎症反应的影响

手术创伤后局部组织损伤产生炎症介质，包括PGs,细胞因子等，它们释放人血产生全身炎症反应，炎症介质还可产生疼痛或痛觉增敏。围术期镇痛应该采用多种药物、方法的多模式镇痛，其中局麻药硬膜外镇痛具有较重要的作用，结合阿片类镇痛药、NSAIDs、超前镇痛等，通过抑制交感活化及炎症介质产生等机制对减轻术后炎症反应，促进术后恢复及结局改善具有重要意义。

Effects of perioperative analgesia on postoperative inflammatory response

Surgery-related local tissue injury leads to release of inflammatory mediators,including prostaglandins(PGs)and cy- tokines,resulting in systemic inflammatory response.They may cause pain or hyperalgesia.Several analgesic agents and methods,re- ferred to as multimodal analgesia,should be combined together in order to acquire efficient perioperative analgesia.Among them,epi- dural analgesia plays an important role.Combination of epidural analgesia,opioids,NSAIDs and preemptive analgesia etc.attenuates inflammation and improves postoperative recovery and outcome,mainly via blocking sympathetic response and inhibiting production of inflammatory mediators.