Clinical Observation Of Morphine Combined With Dexmedetomidine In Patient Controlled Intravenous Analgesia On Postoperative Gastric Cancer Patients

ObjectiveTo observe the effect of morphine combined with Dexmedetomidine in PCIA of analgesia and adverse reactions and immunologic function in gastric cancer patients after abdominal operation.MethodsFrom August 2015 to July 2016 in our department,112 cases of patients with ASA Physical status ?-? were randomly divided into group C(control group)and group D(Dexmedetomidine group).Each group has 56 cases.The PCIA pump was connected immediately after the end of surgery.Group C administrated with morphine(100mg)+Tropisetron HCl(10mg),and group D administrated with morphine(82mg)+Dexmedetomidine(200ug)+Tropisetron HCl(10mg).All the anesthetic agents werw diluted into 200 ml of 0.09 sodium chloride PCIA was fixed as background does of 2 ml/h,does of 2 ml/once and lock time of 15 min.The VSA score was maintained below 4.The Ramsay score was maintained between 2-3.The total mount of morphine consumed the number of attempts and successfully delivered doses within 24 48h after operation were recorded.Postoperative complications including nausea,vomiting,bradycardia,hypotension,over sedation and respiratory depression were recorded.The expressions of T-lymphocyte subsets(CD3+?CD4+?CD8+)and natural killer cells were measured by flowcytometry at five time points:before anesthesia,during extubation,24h,72h,120h after operation.ResultsThe total mount of morphine consumed the number of attempts and successfully delivered doses within 24 48h after operation were significantly smaller and the incidence of nausea and vomiting and pruritus was significantly lower in group D than in group C.No bradycardia,hypotension,over sedation respiratory depression was observed in each group.the trend was not consistent with time shift about the CD3+,CD4+,CD4+/CD8+expression with T cell and NK cell in the two groups and the period at 24 hour was th e lowest after operation and recovered gradually then.Compared with C group,CD3+,CD4+,CD4+/CD8+ T cell and NK cell levels were significantly higher in group CD3 t han in group C(P<0.01)at the 24 hour and 72 hour after operation which indicated th at the immunosuppressive effect of D group was significantly less than that of group B.ConclusionPCIA morphine combined with Dexmedetomidine can achieve the favorable VS A and sedation effect,and reduce the amount of morphine and postoperative untoward effect.It contributes more to recover cell mediate immunity of the patients suffering excision of gastric cancer.