Effect of Dezocine on the Ratio of Th1/Th2 Cytokines in Patients Receiving Postoperative Analgesia Following Laparoscopic Radical Gastrectomy: A Prospective Randomised Study

Abstract

Purpose: To evaluate the effect of dezocine on the postoperative ratio of Th1/Th2 cytokines in patients undergoing laparoscopic radical gastrectomy.

Patients and methods: Sixty patients undergoing laparoscopic radical gastrectomy were randomly divided into two groups (n=30): dezocine group (Group D) and sufentanil group (Group S). They received patient-controlled intravenous analgesia (PCIA) after the operation with either dezocine 0.8 mg/kg (Group D) or sufentanil 2 µg/kg (Group S). Both groups also received ondansetron 8 mg diluted to 100 mL with saline. The primary outcome was the Th1/Th2 cytokines ratio at predetermined intervals, 30 min before the induction of general anaesthesia and 0, 12, 24 and 48 h after surgery. The secondary endpoints were patients' pain scores, measured on a visual analogue scale (VAS) at predetermined intervals (0, 12, 24 and 48 h after surgery), and side effects at follow-up 48 h after surgery.

Results: The Th1/Th2 cytokines ratio in Group D was significantly higher than Group S (P<0.05) 12, 24 and 48 h after the operation. There were no significant differences in VAS pain scores between groups at 0, 12, 24 and 48 h after surgery (P>0.05). Compared to Group S, the incidence of postoperative nausea, vomiting and lethargy was significantly lower in Group D (P<0.05).

Conclusion: Dezocine increases the ratio of Th1/Th2 cytokines, relieves postoperative pain and causes fewer side effects in patients undergoing laparoscopic radical gastrectomy.

Keywords: Th1/Th2 cytokines; dezocine; gastric cancer; laparoscopic radical operation; postoperative analgesia.

Figure 1

Flow diagram of the study.

Figure 2

Evaluation of the ratio of Th1/Th2 cytokines between the two groups 30 min before the induction of general anaesthesia and 0, 12, 24 and 48 h after the operation (30 patients in each group, data are expressed as mean ± SD). *According to the Mann–Whitney U-test, the Th1/Th2 cytokines ratio in Group D was significantly higher than in Group S (P<0.05) 12, 24 and 48 h after the operation. ^#According to the Mann–Whitney U-test, compared to 30 min before the surgery, the Th1/Th2 cytokines ratio in the two groups was significantly lower (P<0.05) 0, 12, 24 and 48 h after the operation. According to the Mann–Whitney U-test, there was no significant difference in the Th1/Th2 cytokines ratio between groups (P>0.05) 30 min before surgery and 0 h after surgery.

Figure 3

Evaluation of the patient-reported pain score (VAS) between the two groups during the postoperative period. Comparison of pain scores of both groups at 0, 12, 24 and 48 h after surgery (30 patients in each group, data are expressed as mean ± SD). There were no significant differences in pain scores between the two groups (according to the Mann–Whitney U-test) during the postoperative period (P>0.05).