Efficacy of dexmedetomidine combined with oxycodone for postoperative patient-controlled intravenous analgesia and its influence on inflammatory factors in laparoscopic resection of rectal cancer

Abstract

Objective To explore the efficacy of dexmedetomidine combined with oxycodone for postoperative patient-controlled intravenous analgesia in laparoscopic resection of rectal cancer and observe its influence on inflammatory factors. Methods Ninety patients underwent laparoscopic resection of rectal cancer in colorectal anus surgical department of the First Affiliated Hospital of Suzhou University from June 2014 to December 2016, were divided into oxycodone group, dexmedetomidine group and combined group using random number table method, 30 cases in each group. The patients were given patient-controlled intravenous analgesia (PCIA) with oxycodone or dexmedetomidine or both oxycodone and dexmedetomidine in the three groups for postoperative analgesia respectively. The medications were diluted to 100 ml with normal saline and the PCIA pump was set up with a 2 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 1 mg/h. The visual analogue scale (VAS) and Ramsay score were recorded at 2, 6, 24 and 48 h after the operation, and the times of pressing button, requirement for rescue analgesic, and side effects were recorded, including fever, nausea, vomiting, lethargy, dizziness, skin pruritus, and respiratory depression. Median cubital venous blood samples were obtained at 1 d before surgery, 1 and 3 d after surgery for determination of serum concentrations of CRP, TNF-α and IL-6 by enzyme-linked immunosorbent assay. Results VAS, PCIA effective press times and adverse reactions were lower in the combined group than those in the oxycodone group and dexmedetomidine group. Serum levels of CRP, TNF-α and IL-6 were all lower in the combined group than those in the oxycodone group and dexmedetomidine group at 72 h after surgery. Conclusion The efficacy of dexmedetomidine combined with oxycodone for postoperative PCIA in laparoscopic resection of rectal cancer is better than that of oxycodone or dexmedetomidine alone, and the level of serum CRP, TNF-α and IL-6 also reduced. Key words: Dexmedetomidine; Oxycodone; Pain, postoperative; Analgesia, patient-controlled; Colorectal surgery