Effects Of Postoperative Analgesia With Butorphanol On Levels Of Serum IL-2, IL-6 And TNF-α

Objective To observe and evaluate Clinical result of butorphanot in patient-controlled intravenous analgesia after surgeries of chest and butorphanot influence on IL-2,IL-6 and TNF-α.Methods1 Clinical Research Thirty ASA(I-II)patients(20-70years)undergoing thoracic operations without no obvious history of hypertension or hepatic and renal abnormalities were screening from Shenyang thorax hospital. After 30 patients Signed postoperative analgesia informed consent book, they received butorphanol 0.15-0.2 mg/kg(A:0.15mg/kg; B:0.17 mg/kg,C:0.20mg/kg). Meanwhile, visual analogue scale score,bruggrmann comfort scale score,Ramsay score,incidence of untoward effects and administration frequency of PCA pressing were assessed at various time points of the end of operation,12 h,24h,36h,48h post operatively.2 Experimental Research According to the results of clinical research,we chose group (butorphanol 0.17mg/kg) which had best analgesic effect and fewest adverse reactions.We selected60 patients who were about to undergo selective operations,aged 20 through 70 years old with their BMIs(Body Mass Index) below 25kg/m2 while their ASA staging between stages I and II.Then divide according to ages the 60 patients into: group A (20-35 years) and TA is control group; group B(36-50 years) and TB is control group; and group C (51-70 years) and TC is control group, each groups have 10 patients. Peripheral blood samples were gather up at 6 different time points of preoperation(T0), the end of operation(T1), and 12h(T2), 24h(T3), 36h(T4), and 48h(T5) after operation and standards of IL-6,IL-2 and TNF-αwere determined by enemzy-combined immunosorbemt assay.ResultsWith the increase of butorphanol drug concentration, VAS,BCS and Ramsay index become tall, but change is not obvious, butorphanol drug concentration in 0.15 ~ 0.20 mg/ml is good medicine effect and is safe. Postoperative adverse reaction: nausea, vomiting, dizziness, drowsiness, abdominal distension sometimes appeare, but is not rising rule as butorphanol drug concentration increasing, butorphanol drug concentration in 0.15 mg/ml is safe drug use scope.A, B and C group compared with the corresponding group, IL-6 level and TNF-αlevel of corres-ponding points of A, B and C group are reduced, And IL-2 levels rise somewhat. The comparison of A, B and C three groups, change rule of IL-2, IL-6, TNF–αis approximate, group C and group A,B have very big difference.ConclusionButorphanol drug concentration in 0.15 ~ 0.20 mg/ml has good medicine effect and is safe. Chest postoperative analgesia adverse reaction: nausea, vomiting, dizziness, drowsiness, abdominal distension sometimes appeared, but is not rising rule as butorphanol drug concentration increasing. Butorphanol PCIA could effectively balance the increases of level of IL-2, IL-6 and TNF-αin postoperative patient's serum, and equilibrium activity is obvious. Older patients are more sensitive to butorphanol, and for the younger patients, the effect of butorphanol is a bit poor. One suggestion is that the dose of butorphanol should somewhat change with patients'age.