Effect Of Pre-emptive Analgesia With Nalbuphine On Inflammatory Factors In Patients Undergoing Gynecological Laparoscopic Surgery

ObjectiveTo observe effect of pre-emptive analgesia with nalbuphine on serum inflammatory cytokine levels in patients undergoing laparoscopic hysterectomy.MethodsA total of 60 patients aged 55-65 years,weighing 55-75 kg,ASAI or II,who underwent laparoscopic hysterectomy in our hospital from January 2018 to October 2018were selected.The patients were divided into the experimental group?group N?and the control group?group C?,30 cases each.10 min before induction of general anesthesia,group N was intravenously injected with nalbuphine hydrochloride injection 0.2mg/kg.Group C was intravenously injected with normal saline.Both groups of general anesthesia and surgical procedures were performed by the same group of physicians.Arterial blood 1.5 ml and peripheral venous blood 3 ml was collected at 30 min before induction?T1?,and at postoperative 2 hours?T2?,6 hours?T3?and 12 hours?T4?.Arterial blood was collected for blood gas analysis.Peripheral venous blood was taken from the patient,centrifuged for 15 min?2000 r/min?,and the upper plasma was collected at-80°C for cryopreservation.The serum interleukin-6?IL-6?,tumor necrosis factor-??TNF-??,and interleukin-10?IL-10?were determined by enzyme-linked immunosorbent assay?ELISA?.Changes of visual analogue scale?VAS?,mean arterial pressure?MAP?,heart rate?HR?,pulse oximetry?SpO₂?and arterial blood carbon dioxide partial pressure?PaCO₂?were recorded at T1 to T4.The incidence of postoperative adverse reactions and the addition of analgesic drugs were recorded.ResultsThe levels of serum IL-6,TNF-?and IL-10 in the two groups were not significantly different at the time of T1?P>0.05?.Compared with T1,the levels of serum IL-6,TNF-?and IL-10 in T2^T4 of the two groups gradually increased with time,the difference was statistically significant?P<0.05?.At the time of T2^T4,serum IL-6 and TNF-?levels in group N were significantly lower than those in group C,and serum IL-10levels were higher than those in group C?P<0.05?.2 There was no significant difference in MAP,HR and VAS scores between the two groups at T1?P>0.05?.The MAP,HR and VAS scores of the two groups were significantly higher than those of T1 at T2,T3 and T4,and the difference was statistically significant?P<0.05?.At the time point of T2^T4,the MAP,HR and VAS scores of group N was lower than that of group C,and the difference was statistically significant?P<0.05?.There was no significant difference in SpO₂ and PaCO₂ between the two groups at T1^T4?P>0.05?.3 The incidence of adverse reactions in group N was lower than that in group C,and the difference was statistically significant?P<0.05?.There was no significant difference in the number of analgesic drugs between the two groups?P>0.05?.ConclusionThe pre-emptive analgesia with nalbuphine hydrochloride is applied to laparoscopic hysterectomy,which can effectively improve postoperative pain,reduce inflammatory reaction,increase patient comfort,and improve patient prognosis.Therefore,preemptive analgesia with nalbuphine hydrochloride can provide an alternative and effective analgesia model for perioperative analgesia in gynecologic laparoscopic surgery.Figure6;Table7;Reference 192.