Effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative IL-6, TNF-α and insulin resistance in patients undergoing abdominal general anesthesia

Abstract

Objective To investigate the effect of sulfentanyl and tropisetron postoperative analgesia pump on perioperative interleukin 6(IL-6), tumor necrosis factor (TNF-α) and insulin resistance in patients undergoing abdominal general anesthesia. Methods From March 2016 to March 2017, 120 patients undergoing elective abdominal surgery in our hospital were selected, all patients were treated with general anesthesia.The patients were randomly divided into control group and observation group according to the digital table, with 60 cases in each group.The control group was treated with on-demand delivery analgesia.The observation group was treated with sulfentanyl and tropisetron postoperative analgesia pump for postoperative analgesia.The BCS score, VAS score, Ramsay score at the end of operation and after operation were compared.The TNF-α, ISI, IL-6, insulin levels and blood glucose levels of preoperation and postoperation were compared between the two groups. Results Compared with the control group, the BCS score and Ramsay score of postoperative 0.5d[(2.78±0.57)points, (2.27±0.39)points], postoperative 1d[(3.04±0.48)points, (2.36±0.50)points], postoperative 1.5d[(3.24±0.51)points, (2.43±0.49)points], postoperative 2d[(3.35±0.43)points, (2.51±0.42)points] in the observation group increased (t=-18.604, -8.65, -8.204, -3.967, t=-9.634, -4.864, -4.610, -2.604, all P<0.05), the VAS scores of postoperative 0.5d[(2.4±1.1)points], postoperative 1 d[(1.8±0.8)points], postoperative 1.5d[(1.7±0.5)points], postoperative 2d[(1.7±0.9)points] in the observation group were lower (t=2.082, 4.834, 7.934, 3.098, all P<0.05). Compared with the control group, the insulin, blood sugar, TNF-α, IL-6 of postoperative 0.5d[(7.26±2.17)mU/L, (5.63±0.58)mmol/L, (148.96±20.31)g/L, (120.54±22.27)pg/mL], postoperative 1d[(7.37±1.74)mU/L, (5.34±0.50)mmol/L, (121.35±21.07)μg/L, (116.35±21.01)pg/mL], postoperative 1.5d[(6.57±2.14)mU/L, (5.11±0.50)mmol/L, (114.36±23.99)μg/L, (113.14±18.05)pg/mL], postoperative 2d[(5.87±1.84)mU/L, (4.87±0.51)mmol/L, (100.02±18.13)μg/L, (91.37±14.88)pg/mL] in the observation group were lower (t=9.374, 11.698, 6.455, 10.161, t=8.557, 13.027, 9.990, 8.541, t=6.730, 7.917, 7.811, 2.326, t=8.003, 7.225, 3.839, -7.618, all P<0.05). Compared with the control group, the ISI of postoperative 0.5d[(24.77±0.26)×1 000], postoperative 1d[(25.03±0.21)×1 000], postoperative 1.5d[(29.65±0.17)×1 000], postoperative 2d[(34.54±0.19)×1 000] in the observation group were increased (t=-281.912, -442.121, -248.226, -431.857, all P<0.05). Conclusion The analgesic effect of sulfentanyl and tropisetron postoperative analgesia pump is good, it can reduce the postoperative stress response and the levels of IL-6 and TNF-α, and reduce the degree of insulin resistance, and can be widely used in clinical. Key words: Analgesia; Anesthesia, general; Analgesics, opioid; Tumor necrosis factor; Interleukin 6; Insulin resistance; Sulfentanyl; Tropisetron