PRACTICAL ONCOLOGY JOURNAL ›› 2018, Vol. 32 ›› Issue (4): 309-314.doi: 10.11904/j.issn.1002-3070.2018.04.005

• Clinical Research • Previous Articles     Next Articles

Comparison between nalbuphine and oxycodone applied for patient controlled analgesia on postoperative immunological factor levels in patients with non-small cell lung cancer

CUI Xiaoyan,TU Qing,GAN Jianhui   

  1. Department of Anesthesiology,The Affiliated Tangshan People Hospital of North China University of Science and Technology,Tangshan 063000,China
  • Received:2018-05-25 Online:2018-08-20 Published:2018-09-06

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Abstract: Objective The aim of this study was to compare the effects of morphine and oxycodone controlled intravenous analgesia(PCIA)on postoperative immunological factor levels in patients with non-small cell lung cancer(NSCLC). Methods Eighty patients with NSCLC who underwent video-assisted thoracic surgical(VATS)lobectomy were enrolled in the study.They were randomly divided into nalbuphine(N group)and oxycodone group(O group).All patients were given PCIA analgesia after operation.Patients in the N group received nalbuphine hydrochloride at dose of 1.0 mg/kg plus 10 mg of tropisetron for PCIA,while patients in the O group received oxycodone hydrochloride 20 mg plus 10 mg of tropisetron,all diluted to 150 mL with physiological saline.Five mL of peripheral venous blood was drawn at 30 min(T0)before surgery and after surgery for 4(T1),8(T2),12(T3)and 24 h(T4)to determine serum levels of IgG,IgM,IgA,TGF-β1,VEGF and IL-17,count the cell number of CD4+T,CD8+T and NK and calculate the ratio of CD4+/CD8+.VAS scores were performed on all patients at T1,T2,T3 and T4. Results There were no significant differences in the VAS scores,PCIA pump effective compressions and total consumption of PCIA between the N and O groups(P＞0.05).Compared to the O group,the serum level of IgG at T1~T4,IgM and IgA serum levels at T2~T4 were high in the N group;serum levels of TGF-β1 and VEGF at T2~T4 and IL-17 serum level at T1~T4 were low in the N group;the number of CD4+T and NK cells,the ratio of CD4+/CD8+ at T2~T4 and the number of CD8+ T at T1~T4 were high in the N group.The differences were statistically significant(P＜0.05). Conclusion Nalbuphine for patients with NSCLC applied for PCIA after VATS lobectomy can effectively control postoperative pain,significantly increase levels of immunoglobulin and immune cells,reduce the level of tumor immunosuppressive factors,reduce perioperative immunosuppression degree,and improve the body's immune function.

Key words: Nalbuphine, Oxycodone, Non-small cell lung cancer, Video-assisted thoracic surgical lobectomy, Immunological factors

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