曲马多和吗啡术后镇痛对肿瘤病人免疫功能的影响

THE EFFECTS OF TRAMADOL AND MORPHINE ON IMMUNE RESPONSES AND PAIN AFTER SURGERY IN CANCER PATIENTS

摘要:

目的 :探讨曲马多、吗啡术后镇痛对肿瘤病人免疫功能的影响。方法 :选取子宫颈癌病人30例 ,常规全麻下行子宫颈癌根治手术 ,术后随机分成两组 (T组和M组 ) ,分别给予曲马多和吗啡进行术后镇痛 ,于术前、术毕给予镇痛药前和给予镇痛药 2h后抽取病人静脉血测定血清T淋巴细胞增殖率、NK细胞活性及病人VAS评分。结果 :两组病人均达到满意的镇痛效果 ,术毕两组病人T淋巴细胞增殖率均明显下降 (P <0 .0 5 ) ,M组持续到术后 2h ,而T组则于术后 2h恢复到术前水平 ,两组间有显著差异 (P <0 .0 5 )。给予镇痛药 2h后NK细胞活性 ,M组无明显变化而T组则有明显增高。结论 :曲马多用于术后镇痛更有利于病人免疫功能的恢复

Abstract:

Objective: To investgate the effects of tramadol and Morphine on immune responses and pain after surgery in cancer patients. Methods: 30 patients prepared to undergo abdominal surgery for uterine carcinoma were allocated randomly to two groups (group T and group M), which were to receive postoperation analgesia with tramadol or Morphine. T lymphocyte proliferation and natural killer cell activity were evaluated immediately before and after surgery, and at 2 h after the acute administration of either 10 mg of morphine I.M. or 100 mg tramadol IM. Results: Both drugs produced a comparable reduction in postoperative pain.In all patients, lymphoproliferation was significantly depressed. However, in the group M, proliferative values remained lower than basal levels at 2 h after treatment, whereas in the group T proliferative values returned to basal levels. Natural killer cell activity was not significantly affected in the group M but significantly enhanced in the group T. Conclusions: Tramadol used for post-operative analgesia produces less immuno-suppressive effect as compared to morphine.