Department of Anesthesiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Thorac Cancer. 2017 Nov;8(6):649-654. doi: 10.1111/1759-7714.12502. Epub 2017 Sep 11.
Tumors may induce systemic immune dysfunction, which can be aggravated by surgery and anesthesia/analgesia. Data on the effect of flurbiprofen preemptive analgesia on immune dysfunction is limited. The aim of this study was to investigate the effect of flurbiprofen preemptive analgesia on lymphocytes and natural killer (NK) cells in patients undergoing thoracotomy and thoracoscopy radical esophagectomy, and to explore the analgesic methods suitable for tumor patients.
This was a randomized controlled pilot study of 89 patients with esophageal cancer treated with surgery at the Henan Cancer Hospital between January 1, 2015 and December 31, 2016. The patients were divided into three groups: group 1, thoracotomy; group 2, thoracoscopy and laparoscopic surgery; and group 3, flurbiprofen, thoracoscopy, and laparoscopic surgery. CD3+, CD19+, NK, CD4+, and CD8+ cells in whole blood were measured by flow cytometry 30 minutes before surgery (T0), at the end of the thoracic section of the procedure (T1), and at the end of the operation (T2).
There were no significant differences in CD3+, CD19+, CD8+, NK, and CD4+ cells between the three groups or regarding the time points during the procedure (all P > 0.05). Thoracotomy and thoracoscopy surgery resulted in similar immunological outcomes.
Flurbiprofen ester preemptive analgesia did not suppress the immune function in patients and could be a safe analgesic method for patients with esophageal cancer undergoing surgery.
肿瘤可能会引起全身免疫功能障碍,而手术和麻醉/镇痛会加重这种障碍。关于氟比洛芬超前镇痛对免疫功能障碍影响的数据有限。本研究旨在探讨氟比洛芬超前镇痛对接受开胸和胸腔镜根治性食管切除术患者的淋巴细胞和自然杀伤(NK)细胞的影响,并探索适合肿瘤患者的镇痛方法。
这是一项在河南肿瘤医院于 2015 年 1 月 1 日至 2016 年 12 月 31 日期间接受手术治疗的 89 例食管癌患者的随机对照初步研究。患者分为三组:组 1,开胸手术;组 2,胸腔镜和腹腔镜手术;组 3,氟比洛芬、胸腔镜和腹腔镜手术。通过流式细胞术测量全血中的 CD3+、CD19+、NK、CD4+和 CD8+细胞,在手术前 30 分钟(T0)、手术结束时(T1)和手术结束时(T2)。
三组之间或手术过程中的各个时间点的 CD3+、CD19+、CD8+、NK 和 CD4+细胞均无显著差异(均 P>0.05)。开胸手术和胸腔镜手术产生了相似的免疫结果。
氟比洛芬酯超前镇痛并未抑制患者的免疫功能,可为接受手术的食管癌患者提供一种安全的镇痛方法。