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剖宫产术后镇痛方法对血清白细胞介素-6和白细胞介素-10水平的影响。

Effects of analgesia methods on serum IL-6 and IL-10 levels after cesarean delivery.

作者信息

Xing Z-M, Zhang Z-Q, Zhang W-S, Liu Y-F

机构信息

Anesthesia Department, No. 1 People's Hospital of Shunde, Foshan, Guangdong Province, China.

Anesthesia Department, No. 1 People's Hospital of Shunde, Foshan, Guangdong Province, China

出版信息

Genet Mol Res. 2015 May 11;14(2):4778-83. doi: 10.4238/2015.May.11.10.

DOI:10.4238/2015.May.11.10
PMID:25966252
Abstract

This study aimed to discuss the effects of 3 different analgesia methods on serum IL-6 and IL-10 in patients after cesarean delivery. Thirty full-term women, who underwent cesarean delivery, were randomly assigned to 3 analgesia groups (10 cases each) as follows: intramuscular injection of 100 mg pethidine (NC group), patient controlled epidural analgesia (PCEA) of 5 mg morphine plus 150 mg ropivacaine (MR group), and patient controlled intravenous analgesia (PCIA) of 150 mg sufentanil plus 5 mg droperidol (SF group). An electronic analgesia pump was available in all 3 groups. At 4, 12, 24, and 48 h after surgery, visual analogue scale (VAS) pain scores were evaluated, IL-6 and IL-10 serum levels were measured, and adverse reactions were documented. The MR and SF groups responded well to analgesia. VAS scores at 12 and 24 h in these 2 groups were significantly lower than those in the NC group (P < 0.05). IL-6 and IL-10 levels were elevated to varying degrees postoperatively in all 3 groups. In the MR and SF groups, no significant difference occurred at each time point (P > 0.05), but compared with the NC group, significant differences were observed at 12 and 24 h (P < 0.05). Both PCIA and PCEA produced good analgesic effect, decreased postoperative level of serum IL-6, promoted release of anti-inflammatory factor IL-10, maintained balance in postoperative serum IL-6 level, and reduced the postoperative inflammatory response. Adverse reactions were significantly higher with epidural morphine than with intravenous sufentanil.

摘要

本研究旨在探讨3种不同镇痛方法对剖宫产术后患者血清白细胞介素-6(IL-6)和白细胞介素-10(IL-10)的影响。30例行剖宫产的足月产妇被随机分为3组镇痛组(每组10例),如下:肌肉注射100mg哌替啶(NC组)、患者自控硬膜外镇痛(PCEA),即5mg吗啡加150mg罗哌卡因(MR组)、患者自控静脉镇痛(PCIA),即150mg舒芬太尼加5mg氟哌利多(SF组)。3组均使用电子镇痛泵。术后4、12、24和48小时,评估视觉模拟评分(VAS)疼痛评分,检测血清IL-6和IL-10水平,并记录不良反应。MR组和SF组镇痛效果良好。这2组在12和24小时的VAS评分显著低于NC组(P<0.05)。所有3组术后IL-6和IL-10水平均有不同程度升高。MR组和SF组在各时间点无显著差异(P>0.05),但与NC组相比,在12和24小时观察到显著差异(P<0.05)。PCIA和PCEA均产生良好的镇痛效果,降低术后血清IL-6水平,促进抗炎因子IL-10释放,维持术后血清IL-6水平平衡,减轻术后炎症反应。硬膜外使用吗啡的不良反应明显高于静脉使用舒芬太尼。

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