Effects of butorphanol combined with dexmedetomidine used during laparoscopic myomectomy of overweight patients on their immune function,postoperative cognition and inflammatory response
Objective:To investigate the effects of butorphanol combined with dexmedetomidine used during laparo-scopic myomectomy of patients on their immune function,postoperative cognition and inflammatory response.Meth-ods:204 overweight patients with the body mass index(BMI)of 24.0-27.9kg/m2 who were scheduled to undergo lapa-roscopic myomectomy treatment in the hospital from January 2020 to October 2022 were selected and were divided into two groups(102 cases in each group).The patients in the control group were given remifentanil and butorphanol for an-algesia and sedation during surgery,while the patients in the observation group were given remifentanil,butorphanol and dexmedetomidine for analgesia and sedation during surgery.The perioperative related indicators,the immune func-tion before and after operation,the cognitive function evaluated by mini mental state examination(MMSE),the pain degree evaluated by visual analogue scale(VAS),the levels of inflammatory response,such as interleukin-6(IL-6),in-terleukin-6(IL-8),tumor necrosis factor alpha(TNF-a)and C-reactive protein(CRP),and the postoperative adverse reactions rate of the patients were recorded and compared between the two groups.Results:There was no significant difference in the operation time of the patients between the two groups(P＞0.05).The intraoperative blood loss and the postoperative exhaust time of the patients in the observation group were significantly less than those of the patients in the control group(all P＜0.05).There were no significant differences in the values of the immune function indexes and the inflammatory indexes before operation,and the scores of MMSE and VAS of the patients between the two groups(all P＞0.05).The levels of IgG(7.25±1.32),IgA(1.59±0.39),IgM(1.06±0.43),CD3(52.69±6.85％)and CD4(38.69±3.24％)of the patients in the observation group at 12 hours after operation were significantly higher than those(6.80±1.65,1.45±0.46,0.95±0.32,49.99％±6.24％and 37.26％±3.16％)of the patients in the control group,and the levels of CD8(35.69±4.21％),IL-6(102.63±32.65 ng/L),IL-8(106.98±13.65 ng/L),TNF-a(162.89±36.77 pg/L)and CRP(32.156.98 Mg/L)of the patients in the observation group at 12 hours after operation were significantly lower than those(38.05％±4.36％,125.62±39.89 ng/L,124.78±14.58 ng/L,179.65±42.05 pg/L and 45.06±7.06 mg/L)of the patients in the control group(all P＜0.05).There were no significant differences in the levels of IgG,IgA,IgM,CD3,CD4,CD8,MMSE,VAS,IL-6,IL-8,TNF-a and CRP of the patients at 24 hours after operation between the two groups(all P＞0.05).There was no significant difference in the postoperative adverse reactions rate(6.9％vs.5.9％)of the patients between the two groups(P=0.580).Conclusion:The combination of bu-torphanol and dexmedetomidine used during laparoscopic myomectomy of the overweight patients can improve their immune function,postoperative cognition and inflammatory response.
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