| Objective:Surgery and truma can trigger the stess-induced inflammatory response. Studies has shown that lidocaine has anti-inflammatory effect.This study aims to observe the effects of intravenous lidocaine infusion on the index of postoperative body temperature, heart rate, white blood cell count and the concentration of HMGB1, IL-6, TNF-a and Syndecanl in plasma and peritoneal fluid of patients reveiving radical hysterectomy,and to explore the underlying mechanismMethods:This study included thirty cervical cancer patients scheduled for for radical hysterectomy under geneal anesthesia. All patients provided written informed consent before the study.Patients were randomly divided into two groups:(1) the lidocaine group(Lgroup, n= 15):1.5mg/kg (5-10min) lidocaine were given in L group 15min before induction of anesthesia followed byl.5 mg.Kg-1. h-1 until the end of surgery(2) the control group(Cgroup,n=15):the same volume of saline was given.Venous blood samples (10ml) were collected before surgery,at the end of the surgery and 0h,3h,6h,12h,24h after surgery. Blood samples were centrifugated and the plasma was collected. Peritoneal fluid was collected 3h after surgery and then 6h,12h,24h after surgery. Peritoneal fluid was collected after centrifugal. The levels of IL-6、 TNF-α,HMGB1 and syndecan1 were measured using human ELISA kit. heart rate, body temperature and white blood cell count were monitored and recored at 3h,6h, 12h,24h after operation.Results:1.There were no statistical differences between the two groups in age,weight,operation time,infusion volume and urine volume (P>0.05).2.Temperature and Heart Rate:The temperature at 3h,6h after surgery in L group was lower than that in C group(36.6±0.275℃,36.86±0.36℃v.s.36.98±0.38℃, 37.49±0.56℃). Compared with C group, the heart rate at 6h after surgery was lower in L group(76.53±9.76vs.92.539±.8 times/min), However, the temperature at other times was no statistical differences between the two groups.3.WBC:Compared with C group, the counts of WBC in L group decreased (8.77±2.9×109/Lvs.12.37±2.18×109/L,P<0.05).4. HMGB 1:Levels of HMGB 1 in the plasma were lower in L group compared to C group 24h after surgery (0.67±0.14vs.0.85±0.05ng/mL,P<0.05) Levels of HMGB 1 in the peritoneal fluid were lower in L group compared to C group 24h after surgery (0.657±0.049 vs.0.683±0.034ng/mL, P< 0.05)5. IL-6:The plasma concentration of IL-6 incrased at 3h,6h,12h after the surgery in two groups.In C group, the plasma concentration of IL-6 at 3h after the surgery was lower than 6h after the surgery (102.76±7.42pg/mLvs.134.4±32.91pg/mL P<0.05) The plasma concentration of IL-6 at 6h was higher than 12h after the surgery(134.4±32.91pg/mLv5.90.48±29.74 pg/ml,P<0.05). There was no difference in the plasma concentration of IL-6 betweeen the 3h and 6h after surgery in L group(85.99±15.61 pg/mLv5.93.72±18.68 pg/mL, P>0.05),However, the plasma concentration of IL-6 at 12h after surgery was lower than 6h after surgery(93.72± 18.68 pg/mLvs.86.71±19.78 pg/mL P<0.05). Compared with group(C) the concentration of IL-6 in L group at 3h,6h after surgery in both plasma and peritoneal fluid were lower. (85.99±15.61 pg/mL,93.72±18.68 pg/mLvs.102.76±7.42pg/mL,134.4±32.91pg/mL, P<0.05) (45.763±13.185 ng/mL, 55.268±10.960 ng/mLvs.101.321±21.828 ng/mL,102.245±15.503 ng/mL, P<0.05) .12h after surgery, the levers of peritoneal fluid IL-6 in L group was lower than C group,too. (61.964±3.994 ng/mLvs.120.97±24.800 ng/mL).6. TNF-α and Syndecanl:There was no statistical differences between the two groups.Conclusions:1.Continuous intravenous infusion of lidocaine in perioperative period can inhibit the increase of white blood cells and reduce the cardiovascular response in patients with cervical cancer.2.Continuous intravenous infusion of lidocaine in perioperative period can inhibit the release of inflammatory factors IL-6 and HMGB1in plasma and peritoneal fluid in patients undergoing radical hysterectomy.3. The results showed lidocaine has the anti-inflammatory effect, which may be related with the inhibition of inflammatory cytokines release. Therefore, lidocaine may be considered as a valuable agent for cervical cancer patients receiving the radical hysterectomy... |
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