高乌甲素伍用芬太尼用于髋关节置换术后镇痛对炎症反应的影响  

Effect of lappaconitine with fentanyl analgesia on inflammatory response after hip replacement

作　　者：胡微澜[1] 叶建新[1] 任珍[1] 

机构地区：[1]河南省新乡市中心医院麻醉科,453000

出　　处：《中国实用医药》2010年第6期17-18,共2页China Practical Medicine

摘　　要：目的观察高乌甲素伍用芬太尼用于髋关节置换术后镇痛对炎症反应的影响。方法择期行髋关节置换手术患者40例,年龄45～75岁;体质量50～70kg;ASAI-11级。随机分为高乌甲素术后镇痛组(A组)和芬太尼术后镇痛组(B组),A组于手术后以芬太尼0.5mg+高乌甲素24mg+赛格恩4mg+生理盐水稀释至100ml,加入一次性镇痛泵行术后患者静脉自控镇痛(PCIA);B组手术后以芬太尼1.2mg+赛格恩4mg+生理盐水稀释至100ml,PCIA泵行术后镇痛。分别于术前(T0)、术后24h(T1)、48h(T2)测肿瘤坏死因子a(TNF-a)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)浓度及白细胞数(WBC)。结果两组术后疼痛视觉模拟评分(VAS)比较差异无统计学意义;A组T2时白细胞数、中性粒细胞数、单核细胞数明显低于B组(P<0.05);两组Tl、T2时IL-6均较T0时显著升高(P<0.01),但A组IL-6明显低于B组(P<0.05);T1时两组IL-10明显升高(P<0.01),A组明显高于B组(P<0.05)。结论高乌甲素伍用芬太尼用于髋关节置换手术后镇痛可减轻术后机体的炎症反应。Objective To observe the effects of postoperative lappaconitine with fentanyl on systemic inflammatory response in patients undergoing hip replacement. Methods Forty patient with the age from 45 to 75,weight between 50 to 70 kg underwent hip replacement were randomly divided into two groups. Group A received PCIA for postoperative analgesia with lappaconitine 24 mg and fentanyl 0. 5 mg and Tropisetron HCl 4 mg and add 0. 9% NaCl to 100 ml ;and group B fentanyl 1. 2 mg and Tropisetron HCl 4 mg and add 0. 9% NaCl to 100 ml. Plasma TNF-a,IL-6,IL-10 and leukocyte count were measured before surgery （T0）,at 24 h （T1）and 48 h （T2） postoperatively. Results VAS scores were not significantly different between two groups. Leukocyte,neutrophil leukocyte and monocyte in group A were significantly lower than those in group B at T2（P〈0. 05）. Serum level of IL-6 in two groups was significantly higher at Tl and T2 than that at To（P〈0. 01）,which was lower in group A than that in groupB（P〈0. 05）. Serum level of IL-10 increased significantly at T2 compared with that at To in both groups（P〈0. 01）,which was higher in group A than that in groupB（P〈0. 05）. Conclusion PCIA with lappaconitine and fentanyl after hip replacement can reduce inflammatory response.

关 键 词：镇痛 芬太尼 高乌甲素 炎症反应 髋关节置换术 

分 类 号：R614[医药卫生—麻醉学]