Kolomachenko Vitaliy Ivanovich
Department of Traumatology, Anaesthesiology and Military Surgery of the Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.
Anaesthesiol Intensive Ther. 2018;50(2):117-121. doi: 10.5603/AIT.2018.0018.
Serum C-reactive protein (CRP) detects the inflammatory response to surgical trauma in hip surgery. It corresponds to the type of surgery, with a higher level of CRP being found in surgery techniques with greater tissue damage. The aim of our study was to analyze the CRP level in serum and drainage blood after hip surgery in patients with coxarthrosis depending on the method of anaesthesia and post-operative analgesia.
65 patients, 58 ± 12 years old, were included in the study. All patients underwent hip replacement surgery due to coxarthrosis. Serum CRP was measured before surgery and on the 1st, 3rd and 7th postoperative days. The CRP level in drainage blood was detected on the 1st, 2nd and 3rd postoperative days. Patients were divided into six groups according to the techniques of intraoperative anaesthesia and postoperative analgesia.
Before surgery, plasma CRP did not differ significantly among the groups. The smallest increase in plasma CRP was found in patients operated on under regional anaesthesia compared with those operated on under general anaesthesia. Postoperatively, the plasma CRP level was higher in patients treated with the systemic administration of opioids+NSAID, than in patients treated with regional analgesia. A significant increase in CRP levels in drainage blood for three days postoperatively was seen in all groups. In patients operated on under general anaesthesia and receiving systemic opioids+NSAID postoperatively, CRP in drainage blood was higher in comparison with those operated on under regional anaesthesia and treated with regional methods of postoperative analgesia.
C-reactive protein levels in plasma and drainage blood depends on the method of anaesthesia and postoperative analgesia after hip surgery. Regional anaesthesia/analgesia methods limit one's inflammatory response to surgical trauma detected by CRP.
血清C反应蛋白（CRP）可检测髋关节手术中手术创伤引起的炎症反应。它与手术类型相关，在组织损伤较大的手术技术中CRP水平较高。我们研究的目的是根据麻醉方法和术后镇痛方式分析髋关节炎患者髋关节手术后血清和引流血中的CRP水平。
65例年龄为58±12岁的患者纳入研究。所有患者因髋关节炎接受髋关节置换手术。在手术前以及术后第1、3和7天测量血清CRP。在术后第1、2和3天检测引流血中的CRP水平。根据术中麻醉和术后镇痛技术将患者分为六组。
术前，各组间血浆CRP无显著差异。与全身麻醉下手术的患者相比，区域麻醉下手术的患者血浆CRP升高幅度最小。术后，全身应用阿片类药物+非甾体抗炎药治疗的患者血浆CRP水平高于区域镇痛治疗的患者。术后三天所有组引流血中CRP水平均显著升高。全身麻醉下手术且术后接受全身阿片类药物+非甾体抗炎药治疗的患者，其引流血中的CRP高于区域麻醉下手术并采用区域术后镇痛方法治疗的患者。
髋关节手术后血浆和引流血中的C反应蛋白水平取决于麻醉方法和术后镇痛方式。区域麻醉/镇痛方法可限制CRP检测到的机体对手术创伤的炎症反应。
