| Surgical trauma and pain in the body will produce a series of reactions of the stress response, including inflammatory and anti-inflammatory cytokines in response, the effective regulation and control of preemptive analgesia can be perioperative stress response and reduce the incidence of postoperative complications. Preemptive analgesia is a measure that prior to the peripheral and central sensitization, in particular the central sensitization.by preventing the central nervous system ,it can relieve pain after allergic extension and amplificationand the stress response caused by the pain and trauma. A lot of information manifest that preemptive analgesia drugs called NSAIDs can reduce postoperative pain, Kay offered is non-steroidal anti-inflammatory analgesic drugs,take lipid microspheres as targeting vector for the analgesic effect of.it inhibits production of prostagland by inhibiting of cyclooxygenase (COX). preemptive analgesia have been applied in the gynecology, some short surgery of orthopedic,But there are not research about the impact of stress-induced inflammatory reaction and pain after thoracic surgery.Objective: the application of preemptive analgesia Kay in the larger thoracic surgery, determinating serum IL-6 in hours and 24 h after the consumption of fentanyl, to explore the thoracic surgery of perioperative inflammatory factor interleukin-6 and postoperative analgesic effect. Methods: 30 cases of lung cancer patients, under general anesthesia undergoing lobectomy to thoracotomy, were randomly divided into two groups: group A (the experimental group) and group B (control group), the two groups have adopted total intravenous anesthesia target-controlled, the patient of group A The intravenous Kay 1mg/kg, respectively at preoperative 20 minutes And the Completion of operation.Group B (control group) no treatment. at preoperative 30 minutes, two groups respectively intravenous fentanyl 0.1 mg, 3 mg granisetron, then fix PCIA pumps: fentanyl 1.5 mg to 150 ml saline (setting parameters: 5 ml capacity, continuing losers Note of 2ml/h, 2ml of PCA, locking time 15 min). Respectively get 3 ml peripheral blood after coming into operating room (T1), perioperative 3h (T2), postoperative 8h (T3) and 24 h(T4),to determinate of serum IL-6 concentration in RIA method,record postoperative 24 hours consumption,adverse reactions of fentanyl and VAS score. postoperative 4,8,12,24 hours.Results: The two groups of a patient's age, weight, operation time, transfusion volume. Statistical analysis showed no significant difference (P>0.05); comparing VAS score of postoperative 4,8,12,24 hours have not statistical significance (P>0.05); postoperative complications between the two groups have not statistical significance. postoperative 24 hours , the consumption of fentanyl in group A is more lower than that of group B, there are statistically significant differences (P<0.05). comparing serum IL-6 concentration in two groups T1 is no statistical significance (P>0.05); T1,T2,T3 of group A was significantly lower than that in group B, there are statistically significant (P<0.05);compaired with T1,T2,T3,T4 in two group is significantly increasing,T3 is the most obvious,T4 begin to descent, but still higher than the preoperative level, the difference is statistically significant (P<0.05).Conclusion: Kay numerous applied in trauma larger thoracic surgery, have the effect of preemptive analgesia, and the effect is affirmative. by inhibiting COX to reduce prostaglandin production, Kay indirectly inhibit the increasing the inflammatory cytokine IL-6, and regulate the stress response in a certain degree . whether the dose of Kay and IL-6 have dose-related pending need further study.
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