Effects Of Postoperative Analgesia With Nalbuphine And Dezocine On Inflammatory Factors In Patients With Meningiomas

Objectives:By observing the analgesic effect of nalbuphine and dezocine on patients with meningiomas craniotomy and detecting serum tumor necrosis factor-a(TNF-?)and interleukin-6(IL-6),interleukin-10(IL-10)levels of inflammatory factors,to explore the effect of postoperative analgesia on inflammatory factors.Methods:Approved by the hospital ethics committee,90 patients with meningioma surgery from January 2017 to January 2019 in the First Affiliated Hospital of Kunming Medical University were randomly divided into:nalbuphine group(group N,n=30),dezocine group(group D,n=30),blank control group(group C,n=30).In the three groups of patients,when the skull closure was started,the group N was given 0.2 mg/kg of nalbuphine intravenously,the group D was given 0.1 mg/kg of dizocine intravenously,and the group C was given an intravenous dose of 0.9%saline.Before the anesthesia induction(TO),the skin incision(T1),the skull closure(T2),the postoperative 2 hours(T3),the postoperative 6 hours(T4),the postoperative 24 hours(T5),the central vein at each time point 4ml of blood samples,serum TNF-?,IL-6,IL-10 levels were measured and observed VAS analgesia score in the three groups of patients when they were awake(T0'),2h after surgery(T1'),6h after surgery(T2'),and 12h after surgery(T3'),24 h after surgery(T4').Results:1.There was no significant difference in the general data(sex,age,weight)between the three groups(P>0.05).2.Pain score:The pain scores of the three groups were scored by double-blind visual analogue scale(VAS).The analgesic effect of the nalbuphine group and the dezocine group was better than that of the blank control group at T0' to T4'(P<0.01).The analgesic effect of the nalbuphine group was better than that of the dezocine group at T0' to T4'(P<0.01).3.The results of three groups of patients with serological indicators3.1 Comparison results of IL-6Comparison within the group:Compared with TO,there was no significant difference in the concentration of T1 at each time.The concentrations of IL-6 in each group at T2,T3,T4 and T5 were increased(P<0.05),especially in the control group.Comparison between groups:At the time of T2,T3,T4 and T5,the increase of IL-6 concentration in the control group was significantly higher than that in the dezocine group and the nalbuphine group,and the increase in the dezocine group was significantly higher than that in the nalbuphine group(P<0.05).3.2 Comparison results of TNF-?Comparison within the group:Compared with T0,the concentration of TNF-? was increased in each group at T1-T5(P<0.05),especially in the blank control group.Comparison between groups:At the time of T2,T3,T4 and T5,the concentration of TNF-? in the blank control group was higher than that in the dezocine group and the nalbuphine group.The concentration of TNF-? in the dezocine group was higher than that of nalbuphine group at T3,T4 and T5(P<0.05).3.3 Comparison results of IL-10Comparison within the group:Compared with T0,IL-10 concentrations in each group increased at T1-T5(P<0.05),especially in the nalbuphine group.Comparison between groups:At the time of T3,T4 and T5,the IL-10 concentration in the nalbuphine group and the dezocine group was higher than that in the blank control group(P<0.05).The IL-10 concentration in the nalbuphine group was higher than that in the dezocine group at T3,T4 and T5(P<0.05).Conclusions:1.Nalbuphine and dezocine can be used for postoperative analgesia in patients with meningiomas craniotomy.2.Postoperative analgesia of nalbuphine and dezocine can reduce the levels of TNF-? and IL-6 in patients with meningiomas and open craniotomy,increase the level of IL-10 and reduce the postoperative inflammatory response.3.The effect of nalbuphine on inhibiting inflammatory response is stronger than that of dezocine.The analgesic effect of nalbuphine is also stronger than that of dezocine.