The Application Of Small Doses Dezocine In Laparoscopic Surgery For Colorectal Cancer

Objective:To investigate the effects of small doses dezocine on the preemptive analgesia action and inflammatory factors of colorectal cancer patients with laparoscopic surgery.Methods:60 patients, aged from 20 to 65, ASA staged I-II, were randomly divided into 3 groups(n=20):control group(Group N), epidural group(Group E) and dezocine group(Group D). All patients were performed general anesthesia with endotracheal intubation, and Patient-Controlled Analgesia after operation. There was no special handling on the patients in group N. Epidural puncture was applied in Group E before general anesthesia, and 3m1 2% lidocaine was given as trail dose when 10 ml 0.375% ropivacaine given at twice before operation. Group D were respectively injected with dezocine 40μg/kg intravenously at 5 minutes before incision and the end of operations. The degree of postoperative pain was accessed by the visual analogue scale (VAS) at the 4h,8h,12h,24h and 2d to 6d after operations. The dosage of analgesic and adverse reactions such as nausea, vomiting and respiratory inhibition were recorded in 48 hours after operations. The acquisition of venous blood samples were at preoperation (Ti), end of operation (T2),4h after operation (T3),24h after operation (T4). IL-6, IL-10 and TNF-a were measured in each time point by means of ELISA.Results:The difference of General conditions(age, height, weight), operation time and anesthesia time was not statistically significant in three groups (P>0.05). The VAS scores of group D were lower than group N at 4h, 8h,12h,24h and 2d to 5d after operations(P<0.05), while group E also lower than group N at these time points(P<0.05). And the VAS score of group D were lower than group E at 24h and 2d after operations(P<0.05). The VAS score of patients in group E were lower than that in group N at the 4 h,8 h,12h,24 h and 2 d to 6 d after operations(P< 0.05). The IL-6, IL-10 and TNF-a plasma concentration of patients in group D and group N in T1 were lower than that in T2, T3 and T4. The IL-6, IL-10 and TNF-a plasma concentrationin in T3 express the highest point, the T4 expression decreased obviously compare with T3(P<0.05), but still above of T1(P<0.05).The IL-6, IL-10 and TNF-a plasma concentration were no differences of patients in group D and group N at T1(P>0.05). The IL-6 and TNF-a plasma concentration of patients in group D were lower than that in group N at T2、T3、T4(P< 0.05). The IL-10 plasma concentration of patients in group D were higher than that in group N at T3、 T4(P<0.05). There were no differences in the incidence of adverse reaction and the tramadol in consumption in the 48 hours after operations among three groups(P>0.05).Conclusion:The intravenous injection of dezocine could relieve postoperative pain and reduce postoperative analgesia drug usage of colorectal cancer patients with laparoscopic surgery. Meanwhile, dezocine could increase the expression of IL-10 also reduce the expression of IL-6 and TNF-a, and didn’t increase the incidence of adverse reactions.