Effect Of Hydromorphone Hydrochloride For Postoperative Analgesia On Immune Function In Patients Undergoing Laparoscopic Radical Resection Of Right Colon Cancer

Study Purpose: To investigate the effect of hydromorphone hydrochloride for postoperative analgesia on immune function in patients undergoing laparoscopic radical resection of right colon cancer?METHODS: From January 2017 to November 2018,a total of 92 patients who underwent laparoscopic colon cancer right colon resection under elective general anesthesia in our hospital for elective treatment were selected as the study subjects.According to the patient's postoperative medication,the 92 patients were divided into four groups: A,B,C and D.Group A was given sufentanil 2 ?g/kg;group B was given hydromorphone hydrochloride 0.1mg/kg and sufentanil 2.0 ? g/kg;group C was given hydromorphone hydrochloride 0.15 mg/kg and Sufentanil2.0 ? g/kg;group D was given hydromorphone hydrochloride 0.15mg/kg and sufentanil 1.0?g/kg.The rest and exercise VAS scores and Ramsay scores were recorded at 6 time points,which included beginning of operation(T0),5min after extubation(T1),postoperative 6h(T2),postoperative 12h(T3),postoperative 24h(T4),and postoperative 48h(T5).Within these 48 hours,The number of PCIA compressions and the remedial status of each group were recorded,and theadverse reactions such as nausea,vomiting,itching,and lethargy were observed.The concentration of adrenaline,cortisol,growth hormone,TNF-?,IL-6 and IL-12 of each group were detected by ELISA.RESULTS: 1.There was no significant difference in the ratio of male to female ratio,age,weight,operative time,tumor location,pathological type,and Ducks staging.2.There was no significant difference in EPI,COR,GH,TNF-?,IL-6and IL-12 between T0 and T1 time groups in the four groups.3.For the comparison of COR after the operation,except for T2 and T3 in group B,the other time points of patients in each group were significantly lower than those in group A.Compared with group B,T2,T3 of group C,T2,T3,and T4 of group D were substantially lower.4.Postoperative GH comparison: Compared with group A,T3 of group C and T3,T4 of group D were significantly lower.5.Postoperative EPI comparison: except for T2,T5 in group B,and T5 in group C and group D,the other groups in each group were significantly lower than those in group A.Compared with group B,T3 of group C and group D were significantly lower.6.There was no significant change in TNF-? in the four groups at each time point.7.In the comparison of IL-6,the T2,T3,T4,T5 of group B,group C,and group D were significantly lower than that of group A.Compared with group B,T2,T3,T4 and T5 of group C and group D were decreased considerably.8.The comparison of IL-12 compared with group A,the T2,T3,T4,T5 in group C and group D,T3,T4 and T5 in group B was significantly increased;Compared with group B,T2,T3 in group C and T2,T3,and T4 in group D increased significantly.9.There wasno significant differences in EPI,COR,GH,TNF-?,IL-6 and IL-12 between the group C and D,at each time point.in the four groups at each time point.10.There was no significant difference in VAS score,Ramsay score,the number of PCIA pressing,the number of remedies for analgesia and the incidence of adverse reactions within 48 hours at any time in each group.Conclusions : 1.Hydromorphone hydrochloride can effectively inhibit perioperative stress response in right colon cancer patient when it is applied in postoperative analgesic for cancer patients.2.Hydromorphone hydrochloride can effectively alleviate the perioperative immune suppression status of right colon cancer patients,and also improve the immune function of tumor patients when it was used for postoperative analgesic.