Effects Of PCIA With Remifentanil On The Changes Of T-Iymphocyte Subsets In Patients With Gastric Cancer After Radical Operation

Objective:To investigate the effects of PCIA with different durgs on the changes of T-Iymphocyte subsets in patients with gastric cancer after radical operation.Method:Sixty patients underwent radical operation of gastric cancer were randomly assigned into three groups:Remifentanil group(R Group),Fentanil group (F group)and not accepted the analgesia treatment group(T Group).All patients were given identical Intravenous-inhalation combined anesthesia.Then patients received postoperative analgesia with Remifentanil after operation in R group,the patients in F group were received post-operative analgesia with fentanil,T Group did not accepted the analgesia treatment.Peripheral blood samples were obtained before anesthesia,after operation for 24h,48h,and72h,respectively.The T-lymphocyte subsets was measured by flow cytometry.The analgesic was evaluated by Visual Analogue scale (VAS) on different times after operations.Result:Firstly, for common situation among three groups, doesn't have significant difference (P>0.05);Secondly, VAS has significant difference in analgesia treatment group and not accept analgesia treatment group (P< 0.05).There was no significant difference in VAS between R group and F group(P>0.05);Thirdly,among three groups,the amount of CD3+,CD4+,CD8+,CD4+/CD8+ lymphocyte significantly decreased after operation for 24h than that before operation(P<0.05);Fourthly,in R group, after operation for 48h the amount of CD3+,CD4+,CD4+/CD8+lymphocyte were recovered nearly to the level before operation, but in F group the amount of CD3+,CD4+,CD8+.CD4+/CD8+lymphocyte) were lower than the level before operation. There were significant differences between the two groups(P<0.05);Fifthly,both in the groups after operation for 72h,the amount of CD3+,CD4+, CD8+,CD4+/CD8+ recovered to the level before operation.Conclusions:Posoperative analgesia with Remifentanil or with fentanil shows a similar postoperative analgesic effect in patients underwent radical operation of gastric cancer,but the remifentanil contributes more to recover cellmediated immunity of the patients suffering excision of gastric cancer.