Issue
Effects of dezocine and ropivacaine infiltration anesthesia on cellular immune function indicators, anesthesia recovery time and pain factors in patients with open liver resection
Corresponding Author(s) : Ronggang Zhu
Cellular and Molecular Biology,
Vol. 66 No. 3: Issue 3
Abstract
The current experiment was carried out to explore the effects of dezocine combined with ropivacaine infiltration anesthesia on the anesthesia recovery time and pain factors of patients with open hepatectomy. A prospective randomized controlled method was used to select 92 patients with open liver cancer resection in our hospital from August 2017 to November 2019. The patients were divided into a study group (n=46) and a control group (n=46) using a computer-generated random number table. Both groups underwent general anesthesia, based on this, the study group was treated with ropivacaine infiltration anesthesia 10 minutes before skin incision, and dezocine was given intravenously 0.5 h before surgery, the control group was anesthetized with ropivacaine 10 minutes before the incision, and was given a saline injection 0.5 h before the operation. Compared the recovery of anesthesia (recovery time of spontaneous breathing, time to open eyes, time to extubation), the incidence of adverse reactions, and cellular immune function indicators (peripheral blood CD4+, CD4+/CD8+, NK cell levels), stress response indicators [serum blood glucose (Glu), norepinephrine (NE), adrenaline (E)], pain factors [serum dopamine (DA), neuropeptide Y (NPY), substance P (SP)] before induction of anesthesia (T0), completion of surgery (T1), 12 hours after surgery (T2), and 24 hours after surgery (T3) between the two groups, and the degree of pain (VAS score) at T2 and T3 were compared between the two groups. The levels of CD4+, CD4+/CD8+, and NK cells in peripheral blood at T1, T2, and T3 in the study group were higher than those in the control group (P<0.05); serum Glu, NE, and E levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); serum DA, NPY, and SP levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); the VAS scores of the study group at T2 and T3 were lower than those of the control group (P<0.05); the time of spontaneous breathing recovery, eyes opening and extubation in the study group were shorter than those in the control group (P<0.05); the incidence of restlessness (4.35%), transient hypertension (6.52%), and cough (2.17%) in the study group were lower than those in the control group (P<0.05). Dezocine and ropivacaine infiltration anesthesia can significantly shorten the recovery time of anesthesia and inhibit pain factor secretion in patients with open hepatectomy and can reduce the body's stress response after surgery, reduce immune function fluctuations, and can reduce the incidence of adverse reactions to anesthesia, and help promote patients' postoperative recovery.
Keywords
Download Citation
Endnote/Zotero/Mendeley (RIS)BibTeX
- Korean Liver Cancer Association.2018 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma. Gut Liver 2019; 13(3):227-299.
- Yu Peng, Li Jiajun, Yin Tianxiang. The influence of laparotomy hepatectomy patients after operation by Ropivacaine continue incision infiltration anesthesia. Chin Med Herald 2018; 15(31):117-120.
- Li J, Bi Y. Effects of Continuous Incision Infiltration with Ropivacaine on Analgesia and Early Rehabilitation of Patients Undergoing Selective Open Hepatectomy for Hepatic Carcinoma. Med Pharmaceutic J Chin People's Liberation Army 2017; 29(9):44-47.
- Bindra TK, Singh R,Gupta R.Comparison of Postoperative Pain After Epidural Anesthesia Using 0.5%, 0.75% Ropivacaine and 0.5% Bupivacaine in Patients Undergoing Lower Limb Surgery: A Double-Blind Study.Anesth Essays Res 2017: 11(1):52-56.
- Na-Na Li MS, Ya-Qin Huang MS, Ling-Er Huang BS, Shao-Hui Guo MS. Dezocine antagonizes morphine analgesia upon simultaneous administration in rodent models of acute nociception. Pain Physician. 2017; 20: E401-9.
- Wang G, Lu Z. Effects of hepatic arterial chemoembolization times on Child-Pugh classification of liver function and CT grading of liver cirrhosis in patients with liver cancer. Anhui Med J 2018; 39(8): 981-984.
- Wang J, Zhang C, Dongjun AN, Wang Y, Han L, Zhao B, Yang L. Percutaneous transhepatic gallbladder drainage for different ASA grading of laparoscopic cholecystectomy in patients with acute cholecystitis. Int J Surg 2018; 45(6):391-6.
- Hospital Authority, Health and Family Planning Commission of the People's Republic of China. Guidelines for the diagnosis and treatment of primary liver cancer (2017 edition). Chin J Dig Surg 2017; 16(7): 635-647.
- National Cancer Centre Singapore. National Cancer Centre Singapore Consensus Guidelines for Hepatocellular Carcinoma.Liver Cancer 2016; 5(2):97-106.
- Zhou J, Sun HC, Wang Z, Cong WM, Wang JH, Zeng MS, Yang JM, Bie P, Liu LX, Wen TF, Han GH. Guidelines for diagnosis and treatment of primary liver cancer in China (2017 Edition). Liver Cancer. 2018; 7(3):235-60.
- Song G, Liu J, Cheng Y. Effect of Sevoflurane on Stress Response and Immune Function During Perioperative Period of Hepatic Carcinectomy in Patients with Liver Cirrhosis. China Pharmaceutic 2018; 27(20): 34-37.
- Zhang Bangjian, Wei Shoucun, Yang Xiaoyan. Effects of dexmedetomidine combined with propofol anesthesia on perioperative serum cytokines and postoperative recovery quality in patients undergoing hepatectomy. J Practic Hepatolog 2019; 22(2):118-121.
- Jiang Y, Fu H, Meng J. Effect of ropivacaine local infiltration anesthesia combined with dezocine intravenous anesthesia on stress response in patients undergoing laparoscopic radical gastrectomy. Clinic Res Practice 2019; 4(10):64-65.
- El Sherif FA, Street EM, al Omara M, City A. Effect of dexmedetomidine added to modified pectoral block on postoperative pain and stress response in patient undergoing modified radical mastectomy. Pain physician. 2018; 21: E87-96.
- Liu J, Men F, Tian X. Effect of Dezocine Combined with Ropivacaine on Postoperative Analgesia, Stress Response and the Immune Function of Patients with Gastric Cancer. J Hebei Med 2017; 23(2):255-259.
- He F, Liu H. Effects of dezocine intravenous anesthesia combined with local infiltration of ropivacaine anesthesia on the stress response during recovery of patients undergoing laparoscopic radical resection of colorectal cancer. Shaanxi M J 2018; 47(1): 20-22.
- Liu Y. Discussion on the analgesic and sedative effects of dezocine on patients with remifentanil combined anesthesia during postoperative wake-up period. Jiangxi Med J 2016; 51(5):463-465.
- Zeng D, Ye H, Ye S. Curative effect observation on dezocine combined with sufentanil for patient-controlled epidural analgesia in patients with total hysterectomy. J Math Med 2017; 30(9): 1345-1347.
- Song P, Wang F. Effect of Dezocine combined with Sufentanil Patient-controlled Intravenous Analgesia on General Pain and Inflammatory Mediators after Laparoscopic Keratectomy. J Hainan Med Univers 2017; 23(13):1822-1824.
- Yuan Y, Zhang H. Effect of thoracic epidural anesthesia combined with intravenous combined anesthesia on immune function and body stress in patients with liver cancer resection. Chin Hepatol 2018; 23(6):514-517.
- Xu Min, Li Baojin, Xu Li. Effect of dexmedetomidine combined with dezocine in PCIA on cellular immune function after hepatic carcinectomy . J Southeast Univers (Med Edition) 2017; 36(1):100-103.
References
Korean Liver Cancer Association.2018 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma. Gut Liver 2019; 13(3):227-299.
Yu Peng, Li Jiajun, Yin Tianxiang. The influence of laparotomy hepatectomy patients after operation by Ropivacaine continue incision infiltration anesthesia. Chin Med Herald 2018; 15(31):117-120.
Li J, Bi Y. Effects of Continuous Incision Infiltration with Ropivacaine on Analgesia and Early Rehabilitation of Patients Undergoing Selective Open Hepatectomy for Hepatic Carcinoma. Med Pharmaceutic J Chin People's Liberation Army 2017; 29(9):44-47.
Bindra TK, Singh R,Gupta R.Comparison of Postoperative Pain After Epidural Anesthesia Using 0.5%, 0.75% Ropivacaine and 0.5% Bupivacaine in Patients Undergoing Lower Limb Surgery: A Double-Blind Study.Anesth Essays Res 2017: 11(1):52-56.
Na-Na Li MS, Ya-Qin Huang MS, Ling-Er Huang BS, Shao-Hui Guo MS. Dezocine antagonizes morphine analgesia upon simultaneous administration in rodent models of acute nociception. Pain Physician. 2017; 20: E401-9.
Wang G, Lu Z. Effects of hepatic arterial chemoembolization times on Child-Pugh classification of liver function and CT grading of liver cirrhosis in patients with liver cancer. Anhui Med J 2018; 39(8): 981-984.
Wang J, Zhang C, Dongjun AN, Wang Y, Han L, Zhao B, Yang L. Percutaneous transhepatic gallbladder drainage for different ASA grading of laparoscopic cholecystectomy in patients with acute cholecystitis. Int J Surg 2018; 45(6):391-6.
Hospital Authority, Health and Family Planning Commission of the People's Republic of China. Guidelines for the diagnosis and treatment of primary liver cancer (2017 edition). Chin J Dig Surg 2017; 16(7): 635-647.
National Cancer Centre Singapore. National Cancer Centre Singapore Consensus Guidelines for Hepatocellular Carcinoma.Liver Cancer 2016; 5(2):97-106.
Zhou J, Sun HC, Wang Z, Cong WM, Wang JH, Zeng MS, Yang JM, Bie P, Liu LX, Wen TF, Han GH. Guidelines for diagnosis and treatment of primary liver cancer in China (2017 Edition). Liver Cancer. 2018; 7(3):235-60.
Song G, Liu J, Cheng Y. Effect of Sevoflurane on Stress Response and Immune Function During Perioperative Period of Hepatic Carcinectomy in Patients with Liver Cirrhosis. China Pharmaceutic 2018; 27(20): 34-37.
Zhang Bangjian, Wei Shoucun, Yang Xiaoyan. Effects of dexmedetomidine combined with propofol anesthesia on perioperative serum cytokines and postoperative recovery quality in patients undergoing hepatectomy. J Practic Hepatolog 2019; 22(2):118-121.
Jiang Y, Fu H, Meng J. Effect of ropivacaine local infiltration anesthesia combined with dezocine intravenous anesthesia on stress response in patients undergoing laparoscopic radical gastrectomy. Clinic Res Practice 2019; 4(10):64-65.
El Sherif FA, Street EM, al Omara M, City A. Effect of dexmedetomidine added to modified pectoral block on postoperative pain and stress response in patient undergoing modified radical mastectomy. Pain physician. 2018; 21: E87-96.
Liu J, Men F, Tian X. Effect of Dezocine Combined with Ropivacaine on Postoperative Analgesia, Stress Response and the Immune Function of Patients with Gastric Cancer. J Hebei Med 2017; 23(2):255-259.
He F, Liu H. Effects of dezocine intravenous anesthesia combined with local infiltration of ropivacaine anesthesia on the stress response during recovery of patients undergoing laparoscopic radical resection of colorectal cancer. Shaanxi M J 2018; 47(1): 20-22.
Liu Y. Discussion on the analgesic and sedative effects of dezocine on patients with remifentanil combined anesthesia during postoperative wake-up period. Jiangxi Med J 2016; 51(5):463-465.
Zeng D, Ye H, Ye S. Curative effect observation on dezocine combined with sufentanil for patient-controlled epidural analgesia in patients with total hysterectomy. J Math Med 2017; 30(9): 1345-1347.
Song P, Wang F. Effect of Dezocine combined with Sufentanil Patient-controlled Intravenous Analgesia on General Pain and Inflammatory Mediators after Laparoscopic Keratectomy. J Hainan Med Univers 2017; 23(13):1822-1824.
Yuan Y, Zhang H. Effect of thoracic epidural anesthesia combined with intravenous combined anesthesia on immune function and body stress in patients with liver cancer resection. Chin Hepatol 2018; 23(6):514-517.
Xu Min, Li Baojin, Xu Li. Effect of dexmedetomidine combined with dezocine in PCIA on cellular immune function after hepatic carcinectomy . J Southeast Univers (Med Edition) 2017; 36(1):100-103.