Evaluation of the effects of different postoperative analgesic modalities on postoperative analgesia in patients with esopha-geal cancer and their effects on cytokines
Objective To explore the effects of patient-controlled epidural analgesia(PCEA)and patient-controlled intrave-nous analgesia(PCIA)on postoperative analgesia and cytokine levels in serum on patients undergoing resection of esophageal carcino-ma.Methods Thirty-six patients scheduled for elective resection of esophageal carcinoma were assigned to PECA group(21 cases)or PCIA group(15cases)according to the random number table method in a 3:2 ratio.Based on the same other anesthetics in the two groups,the patients in the PCEA group received combined use of ropivacaine(0.15％)and fentanyl(2 mg/L)for PCEA,while the pa-tients in the PCIA group used fentanyl(12 μg/kg)for PCIA as an analgesic regimen.The general information of patients in both groups,postoperative Numerical Rating Scale(NRS)scores at 2,4,8,16,24,36 h and 48 h for rest and movement,and the occurrence of post-operative adverse events were recorded.The serum levels of interleukin(IL)-1β,IL-6,IL-10,and tumor necrosis factor-α(TNF-α)at preoperative,end of the surgery,24 h and 48 h after the surgery were measured in both groups.Results There were no statistically significant differences in general patient information between the two groups(all P＞0.05).The NRS scores at rest and during movement in the PCEA group were lower than those in the PCIA group at 4,8,16,24 h and 36 h after surgery(all P＜0.05).However,there was no statistically significant difference in NRS scores at rest and during movement between the two groups at 2 h and 48 h after surgery(all P＞0.05).There were no statistically significant differences in the incidence of adverse events between the two groups(all P＞0.05).Serum IL-6 levels in the PCEA group were lower than those in the PCIA group at 48 h postoperatively(P＜0.05).In addition,the serum levels of IL-1β,IL-6,and IL-10 in the PCEA group at 48 h after surgery were lower than the levels at 24 h after surgery(all P＜0.05).There was no statistically significant difference between the two groups for the remaining indicators(all P＞0.05).Conclusions Epidural analgesia was superior to intravenous analgesia for patient-controlled postoperative pain relief after esophagectomy and reduced serum IL-6 levels at 48 h after surgery.
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