Effect Of Patient-Controlled Intravenous Analgesia On Plasma IL-6,IL-10,IL-2,TNF-α In Sinus Surgery

Objective To evaluate the appling of patient-controlled intravenous analgesia in the endoscopic sinus surgery by operating endoscopic sinus surgery in patients with pain and its effect on cytokines IL-6,IL-10,IL-2and TNF-α.Methods Forty patients scheduled for PCIA after FESS were randomly divided into 2 groups:experimental group(n=20, Sufentanil 0.002mg.kg-1 normal saline dilute to 100ml )and control group(n=20, Nimesulide 0.1g,P.O,when VAS>4 or analgesic requirements in patients).PCIA was initiated after extubation with 5ml bolus solution followed by constant at rate of 2ml/h .A dose of 0.5ml solution woud be added when pain was felt and the lockout time ws 15 minutes.The differences of VAS, Simplify the McGill pain questionnaire, blood pressure, blood oxygen, heart rate, breathing and the incidence of adverse reactions were compared in the two groups at each time point. Blood serum concentrayions of IL-6,IL-10,IL-2and TNF-αwere mearsured before and at postoperative 8h,24 h and 48h.Results Satisfaction with the analgesic effect of the experimental group.VAS score: control group was significant higher than experimental group(P<0.05).No significant differences between the two groups in blood pressure, blood oxygen, heart rate, breathing(P>0.05). Simplify the McGill pain questionnaire: control group was significant higher than experimental group(P<0.05). Postoperative blood glucose: control group was significant higher than experimental group(P<0.05). There was significant increase in the level of IL-6 and IL-10 in all groups comparing with the level before anesthesia(P<0.05), IL-6 in control group increased significantly compared with the experimental group at postoperative time point(P<0.05),IL-10 in the experimental group afterincreased significantly compared with the control group at postoperative time point (P <0.05).There was significant increase in the level of TNF-αin all groups comparing with the level before anesthesia(P<0.05), TNF-αin control group increased significantly compared with the experimental group at postoperative time point(P<0.05), IL-2 in the experimental group afterincreased significantly compared with the control group at postoperative time point (P <0.05),there were no significant differences in plasma IL-2 among postoperative 8h,24 h and 48h in experimental group.Conclusion Through observation of the subjective and objective indicators,the assessment of pain extent,pain nature and emotional experience after endoscopic sinus surgery is more objective and accurate.Patient-controlled intravenous analgesia can provide efficient effect in maintainging the balance of pro/anti-inflamatory cytokines, ease postoperative immune injury.