星状神经节阻滞对腹部术后疼痛及白介素8、10的影响  

Effect of stellate ganglion block on postoperative analgesia,IL-8 and IL-10 in abdominal operation

作　　者：张宏金[1] 徐敏[2] 张晓群[1] 马红霞[1] Zhang Hongjin Xu Min Zhang Xiaoqun et al(Department of Anaesthesiology,the Second People＇s Hospital of Lianyungang,Lianyungang 20003)

机构地区：[1]江苏省连云港市第二人民医院麻醉科,200032 [2]江苏省连云港市第二人民医院神经康复科,200032

出　　处：《中国现代医药杂志》2016年第9期16-19,共4页Modern Medicine Journal of China

基　　金：江苏省连云港市重点人才资助项目(编号:ZC095)

摘　　要：目的探讨星状神经节阻滞对腹部手术后疼痛及IL-8和IL-10的影响。方法选择ASAⅠ~Ⅱ级拟行胃及直肠癌根治术的患者80例,分为对照组和星状神经节阻滞（SGB）组,各40例。观察术后1h、4h、24h的VAS评分、镇静评分、IL-8和IL-10的血浆浓度、镇痛药物芬太尼的用量以及不良反应的发生率。结果两组术后1h VAS评分无明显差异,术后4h、24h VAS评分SGB组明显小于对照组（P〈0.05）。两组术后1h疼痛药物用量无明显差异,术后4h、24h SGB组镇痛药物用量明显小于对照组（P〈0.05）。术后1h、4h、24h两组镇静评分比较无明显差异;术后两组之间并发症的发生率比较无明显差异（P〉0.05）;两组术后1h、4h、24h血浆IL-8及IL-10的浓度与术前比较明显升高（P〈0.05）。SGB组术后1h、4h、24h的IL-8血浆浓度明显低于对照组（P〈0.05）;与对照组相比,SGB组术后1h、4h、24h的IL-10血浆浓度明显高于对照组（P〈0.05）。结论 SGB能减轻术后疼痛及减少镇痛药的用量,是临床上一种辅助镇痛的安全、有效的方法 。Objective To investigate the effect of stellate ganglion block（SGB） on postoperative analgesia,IL-8 and IL-10 after abdominal operation. Methods 80 ASA Ⅰ-Ⅱ patients underwent radical operation for stomach and colorectal cancer randomly were divided into control group（40 cases） and SGB group（40 cases）. Visual analog scores（VAS）, Ramsay Scores（RSS）plasma, the concentration of IL-8 and IL-10, the dose of fentanyl, the incidence of adverse reaction was assessed at 1h、4h、24h postoperation. Results Postoperatively 1h VAS of two groups had no significant difference,the VAS at 4h、24h postoperatively of SGB group was significantly lower than that of control group（P〈0.05）. There were no significantly differences between the two groups in Ramsay scores and postoperative complication rates at postoperative（P〉0.05）. The plasma concentration of IL-8 in group SGB was significantly lower than in control group at 1h、4h、24h postoperatively（P〈0.05）. The plasma concentration of IL-10 in group SGB was significantly higher than that of control group（P〈0.05）. Conclusion SGB could improve the effect of postoperative analgesia and reduce postoperative analgesic drug dosage. It is an effective and safe way for postoperative analgesic.

关 键 词：星状神经节阻滞 术后疼痛 细胞因子 

分 类 号：R614.4[医药卫生—麻醉学]