上腹部手术麻醉围手术期炎性细胞因子的影响
IL6,,IL6;,IL8;,IL10;,麻醉,方法;,应激反应,1材料和方法,2结果,3讨论,【参考文献】
【Abstract】 AIM: To evaluate the influence of different anesthetic techniques on the plasma levels of interleukin6 (IL6), interleukin8 (IL8) and interleukin10 (IL10) in patients undergoing major upper abdominal surgery. METHODS: Thirtytwo ASAⅠ-Ⅱ patients scheduled for major upper abdominal surgery were randomly divided into two groups: General anesthesia group (GA group, n=16), in which anesthesia was induced with fentanyl, propofol and vecuronium and maintained with fentanyl and vecuronium as well as enflurane inhalation. General combined epidural anesthesia group (GEA group, n=16): In which general anesthesia was used as in group GA and epidural block with 15 g/L lidocaine was performed before induction. The levels of plasma IL10, IL6 and IL8 were determined with an enzymelinked immunosorbent assay at preanesthsia, 0, 2 and 4 h during surgery and at the end of the surgery, followed by sampling on the morning of the first day and the third day postoperatively. RESULTS: Before anesthesia and 0 h of the surgery, no IL10 was detected. In all the patients, the plasma levels of IL10 showed significant elevations and achieved maximal value 4 h after the skin incision. The plasma levels of IL10 returned to preanesthesia levels on the third day postoperatively. The plasma levels of IL6 and IL8 also increased in the preioperative period. The plasma IL10 levels of group GEA were significantly lower than those of group GA on 4 h after the skin incision and the first day postoperatively. CONCLUSION: General anesthesia combined epidural block has a better inhibitory effect on the stress response in major upper abdominal surgery and may prevent the increase of inflammatory cytokine in the perioperative period. ......
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