国际麻醉学与复苏杂志   2013, Issue (6): 6-6
    
帕瑞昔布钠超前镇痛对乳腺癌改良根治术患者IL-6与C反应蛋白的影响
曹文超, 陈红, 王国年, 赵海芳1()
1.哈尔滨医科大学附属肿瘤医院
Effect of preemptive analgesia with parecoxib sodium on interleukin-6 and C-reactive protein level in patients undergoing radical excision of breast cancer
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摘要:

【摘要】 目的 探讨帕瑞昔布钠超前镇痛对乳腺癌改良根治术患者术后IL-6与C反应蛋白水平的影响,并评价其镇痛效果。方法 选择拟全麻下行乳腺癌改良根治术患者60例,随机分为3组(n=20):超前镇痛组(A组)、空白对照组(B组)和术后镇痛对照组(C组),分别在麻醉诱导前10min或术毕时对A、C组患者静脉注射帕瑞昔布钠40mg/2ml。于麻醉诱导前10min(T1)、术后1h(T2)、6h(T3)、24 h(T4)采集静脉血样,检测血清IL-6和C反应蛋白水平,并采用视觉模拟评分法(VAS)进行术后疼痛评分。 结果 与术前比较,三组患者术后各时点IL-6与C-反应蛋白水平显著升高(P

关键词: 帕瑞昔布钠;乳腺癌;超前镇痛;IL-6;C-反应蛋白
Abstract:

【Abstract】 Objective To investigate the preemptive analgesia of parecoxib sodium on interleukin-6 and C-reactive protein level in patients undergoing radical excision of breast cancer, and to evaluate its analgesic effect. Methods Sixty ASAⅠ-Ⅱpatients undergoing radical excision of breast cancer were randomly divided into 3 groups (n = 20): preemptive analgesia group (group A), blank control group (B) and postoperative analgesia group (C group), patients of group A and C received intravenous parecoxib sodium 40mg before 10 min or at the end of surgery. Blood samples were collected from the patients before anesthesia induction and 1,6,24 h after surgery for the plasma levels of interleukin-6 and C-reactive protein.Analgesic efficacy was assessed after surgery based on visual analog scales (VAS). Results Compared with the level before the induction of anesthesia,The plasma levels of IL-6 and C-reactive protein were significantly higher than preoperative in three groups at different time points (P <0.01), and increased gradually in group B,and there were very significant difference between the time point of 1 h and 24 h after surgery(P<0.01). Between the two groups: The plasma levels of IL-6 and C-reactive protein of group A were significantly lower than group B and group C (P <0.01 or 0.05), VAS at group A and group C at 1, 2, 4, 6hours were significantly lower than group B (P <0.05), There were no significant differences at 12,24h in three groups. Conclusion Preemptive analgesia with parecoxib can be achieved good analgesic effect and can effectively inhibit the postoperative of IL-6 and C-reactive protein level increased, inflammation and stress response of the regulatory body's immune protective effect to promote postoperative recovery.

Key words: parecoxib; breast cancer; preemptive analgesia; interleukin-6; c-reactive protein