Effect Of Low Dose Naloxone On The Immune System Function Of Patient Controlled Analgesia On Sufentanil Undergoing A Video Assisted Thoracoscopic Resection Of The Lung Cancer: A Randomized Controlled

Objective:Opioid receptor antagonists are widely used in clinical practice.In recent years,more and more studies have found that low dose of opioid receptor blockers can inhibit tumors through OGF?opioid growth factor?.In addition,some studies have shown that low dose of opioid receptor blockers can improve the effect of postoperative analgesia,reduce the dosage of opioid drugs and the incidence of adverse opioid-related reactions,such as nausea,vomiting,pruritus,etc.The purpose of this study is to add low dose of opioid receptor blocker naloxone into the of postoperative analgesic solution and observe the immune function as well as analgesic effect and adverse reactions caused by opiates.Methods:Seventy patients?n=70?with lung cancer undergoing thoracoscopic resection under general anesthesia are selected as the study subjects.Low flow oxygen inhalation is performed in the operation room,the basic vital signs such as heart rate,oxygen saturation,invasive arterial blood pressure and bispectral index?BIS?are monitored.Anesthesia was induced with midazolam 0.1 mg/kg,sufentanil 0.5 ug/kg,cisatracurium0.2 mg/kg and propofol 1.5 mg/kg.Anesthesia maintained with propofol,remifentanil and cisatracurium and the depth of anesthesia was maintained at a bispectral index value of 40 to 60.The analgesic pump was used at the end of the operation.Sufentanil 0.04ug/?kg·h??calculated at 48 hours?,palonosetron 0.5 mg and saline diluted to 100 mL were used in group S,in addition,0.05?g/?kg·h?was added in group N on the basis of group S.The analgesic pump capacity was 100 mL,PCA dose was 2 mL/h,PCA bolus was 2 mL,locking time was 20 mins.The analgesic pump was connected after the recovery of anesthesia.Rescue analgesia was performed by intramuscular injection of Sauteralgyl in both groups.2 mL elbow vein blood of Preoperative T₀,postoperative 24h T₁,and postoperative 48h T₂ were placed in EDTA.The collection of blood send to the Central Laboratory of our hospital for the detection of flow cytometry T cell subsets and the percentage of NK cells;The surplus samples were placed at room temperature for 2 h,and centrifuged to extract serum.The samples were stored in a refrigerator at-80?.ELISA was used to detect the concentration of OGF after the samples were all collected.Results:Compared with group S,the level of OGF in group N increased significantly24 hours and 48 hours after operation,and the difference was statistically significant?P<0.01?.Compared with group S,the ratio of NK cells in group N increased 48 hours after operation,and the difference was statistically significant?P<0.01?.Compared with group S,the ratio of CD4⁺/CD8⁺in group N increased significantly 48 hours after operation?P<0.01?.Compared with group S,the dosage of analgesics in group N decreased significantly?P<0.05?.The resting VAS score of group N decreased 48hours after operation,and the difference was statistically significant?P<0.05?.Compared with group S,24 hours after operation,nausea and vomiting scores in group N were significantly lower?P<0.05?.Conclusion:Low dose naloxone can increase the level of OGF in two days after operation,and may improve the immune function of the body on the second day after operation by affecting the level of OGF.Low dose naloxone can enhance the analgesic effect of sufentanil,reduce the dosage of analgesics after operation,reduce nausea and vomiting on the first day after operation,enhance the analgesic effect of sufentanil and may also increase the level of endogenous OGF in vivo.