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| Effects of Perioperative Analgesia with Ropivacaine Combined with Sufentanil on Immune Function and Serum Tumor Markers in Patients Undergoing Radical Resection of Rectal Cancer |
| TAN Guangye, YANG Yingchun, ZHOU Linrong, et al |
| Hospital of Yulin Red Cross Society, Guangxi Yulin 537000, China |
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Abstract Objective: To observe the effects of ropivacaine lumbar muscle block (QLB) combined with sufentanil patient-controlled intravenous analgesia (PCIA) on immune function and serum tumor markers in patients undergoing radical resection of rectal cancer. Methods: 110 cases of patients undergoing elective radical resection of rectal cancer were selected and randomly divided into QLB group (n=55) and control group (n=55). QLB group was treated with QLB after general anesthesia induction (20ml of 0.375% ropivacaine per side), and control group was not given QLB, and they were given sufentanil PCIA after operation. The systolic blood pressure difference (ΔSBP), diastolic blood pressure difference (ΔDBP), heart rate difference (ΔHR) and postoperative pain visual analogue scale (VAS) score were compared between the two groups before and after slicing. The consumption amount of intraoperative fentanyl and postoperative sufentanil, compression time of first analgesic pump and remedial analgesia cases were recorded. The serum immunoglobulin (IgA, IgG, IgM), carcinoembryonic antigen (CEA), carbohydrate antigen125 (CA125) and CA199 were detected before operation and at 24h after operation. Results: Compared with control group, ΔSBP, ΔDBP and ΔHR were significantly decreased in QLB group (P<0.05), and the pain VAS scores were significantly decreased at 6h, 12h and 24h after operation (P<0.05). Compared with control group, the consumption amount of intraoperative fentanyl and the consumption amount of postoperative sufentanil were significantly decreased in QLB group (P<0.05), and the compression time of first analgesic pump was significantly later (P<0.05), and the proportion of remedial analgesia was significantly lower (P<0.05). The levels of serum IgA, IgG and IgM in both groups at 24h after operation were significantly lower than those before operation (P<0.05), and the changes in QLB group were smaller than those in the control group (P<0.05). There were no obvious changes in levels of CEA, CA125 or CA199 in the control group at 24h after operation, compared with those before operation (P<0.05). However, levels of CEA, CA125 and CA199 in QLB group were significantly lower than those before operation (P<0.05), and the changes were greater than the control group (P<0.05). Conclusion: Ropivacaine QLB combined with sufentanil PCIA can significantly reduce the consumption amount of opioids, improve the analgesic effects, reduce the immunosuppression, and effectively reduce the levels of serum tumor markers.
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2019, Vol. 25 
