帕瑞昔布钠超前镇痛对骨关节手术后镇痛及炎性因子水平的影响

目的研究以帕瑞昔布钠行超前镇痛对骨关节手术后镇痛及患者围术期血清白细胞介素6(IL-6)和白细胞介素10(IL-10)水平的影响。方法 60例患者,在腰硬联合麻醉下行骨关节手术,随机分为两组:对照组(不施行超前镇痛)和试验组(麻醉前静注帕瑞昔布钠),各30例,两组术后均采用舒芬太尼静脉自控镇痛;分别于麻醉诱导前(T1),术毕(T2),术后6 h(T3),术后24 h(T4)抽取静脉血,采用酶联免疫吸附法测定血清IL-6、IL-10浓度,并于术后不同时点采用视觉模拟评分法评价术后镇痛效果和不良反应的发生率。结果试验组血清IL-6浓度在T2、T3、T4时点明显低于对照组(P<0.05);IL-10浓度在T2、T3、T4时点明显高于对照组(P<0.05)。试验组在术后2、4、6、8、12 h的视觉模拟评分法评分显著低于对照组(P<0.01)。结论骨关节手术前给予帕瑞昔布钠能产生良好的超前镇痛效应,减少炎性因子的产生,有利于术后恢复。

Effects of Pre-emptive Analgesia with Parecoxib Sodium on Postoperative Analgesia and Levels of Inflammatory Cytokines in Patients Undergoing Joint Operation

Objective To study the effects of pre-emptive analgesia with parecoxib sodium on postoperative analgesia and serum levels of IL-6 and IL-10 in patients undergoing joint operation.Methods 60 patients who were to undergo joint operation,were randomly divided into two groups,each group of 30 cases:control group(without pre-emptive analgesia);parecoxib group(received intravenous parecoxib);all patients received sufentanil postoperative analgesia with patient controlled intravenous analgesia(PCIA).Venous blood was drawn before anesthesia induction(T1),immediately after the end of operation(T2),6h after operation(T3),24h after operation(T4),for determination of plasma IL-6 and IL-10 levels by enzyme-linked immunosorbent assay.Postoperative analgesia effect was evaluated by visual analogue scale(VAS)and analgesic-related adverse effects.Results Compared to the control group,the plasma levels of IL-6 decreased obviously and IL-10 increased obviously in the parecoxib group at T2,T3,T4(P<0.05);the VAS in the parecoxib group after operation 2,4,6,8,12 h was significantly lower than the control group(P<0.01).Conclusion Pre-emptive analgesia with parecoxib can produce good pre-emptive analgesia effect,reduce the production of inflammatory cytokines and have a positive effect on postoperative recovery.