罗哌卡因和地佐辛超前镇痛对手术后血浆IL-1的影响

目的研究罗哌卡因和地佐辛超前镇痛对术后疼痛及IL-1的影响。方法选取胆囊结石行腹腔镜胆囊切除术患者20例,按随机数字表法分为罗哌卡因和地佐辛超前镇痛组（L组）和对照组（C组）,每组10例。L组麻醉诱导前20 min硬膜外腔分次注入含0.25%甲磺酸罗哌卡因4 mL、静脉注射地佐辛5 mg,关闭腹膜时硬膜外腔给予生理盐水10 mL;C组麻醉诱导前20 min硬膜外腔给予生理盐水10 mL,关闭腹膜时硬膜外腔注入含0.25%甲磺酸罗哌卡因4 mL、静脉注射地佐辛5 mg。结果静息时VAS评分术后24、48、72 hL组均显著低于C组（P〈0.05）,咳嗽时VAS评分术后48、72 hL组均显著低于C组（P〈0.05）,术后血浆IL-1水平L组明显低于C组（P〈0.05）。结论罗哌卡因和地佐辛超前镇痛能明显减轻患者手术后的疼痛和减少炎症介质IL-1的表达。

Influence of Preemptive Analgesia with Ropivacaine and Dezocine on Postoperative Level of Plasma IL-1

Objective To explore the influence of preemptive analgesia with ropivacaine and dezocine on postoperative pain and interleukin-1（ IL-1） level. Methods Twenty patients scheduled for laparoscopic cholecystectomy for cholecystolithiasis were randomly divided into two groups,with 10 patients in each group. The preemptive analgesia group（ group L） was given epidural injection of 0. 25% ropivacaine mesylate（ 4 m L） and intravenous injection of dezocine（ 5 mg） 20 minutes before anesthesia induction and epidural injection of normal saline（ 10 m L） at the time of peritoneal closure. The control group（ group C）was given epidural injection of normal saline（ 10 m L） 20 minutes before anesthesia induction and epidural injection of 0. 25% ropivacaine mesylate（ 4 m L） and intravenous injection of dezocine（ 5 mg） at the time of peritoneal closure. Results Compared with group C,VAS scores at rest at 24,48 and 72 hours after operation,VAS scores after coughing at 48 and 72 hours after operation,and plasma IL-1 level after operation significantly decreased in group L（ P〈0. 05）. Conclusion Preemptive analgesia with ropivacaine and dezocine can alleviate the postoperative pain and decrease the expression of inflammatory mediator IL-1.