Impacto da analgesia pós‐toracotomia com dexmedetomidina e morfina em imunócitos: estudo randomizado

Objective

This study aimed to investigate the impact of post‐thoracotomy analgesia with dexmedetomidine and morphine on immunocytes.

Methods

A total of 118 patients with post‐thoracotomy Patient‐Controlled Intravenous Analgesia (PCIA) in our hospital from March 2016 to July 2018 were randomly selected and divided into the Composite (COM) Group (57 patients administered with dexmedetomidine [1.0 μg.kg^‐1 body weight] and morphine [0.48 mg.kg^‐1 body weight]) and the Morphine (MOR) Group (61 patients administered with morphine [0.48 mg.kg^‐1]). The values of lymphocyte subsets (CD3+, CD4+, and CD8+) and Natural Killer cells in the peripheral blood of these two groups were detected by FACSCalibur flow cytometry at different time points (before anesthesia induction [T0], immediately after tracheal extubation [T1], 12 hours after surgery [T2], 24 hours after surgery [T3], 48 hours after surgery [T4], 72 hours after surgery [T5], and 7 days after surgery [T6]). The doses of morphine at T3 to T5 and the adverse reactions between the two groups were also recorded and compared.

Results

The CD3+ level and the CD4+/CD8+ ratio at T2 to T5 and the CD4+ level and NK cells at T3 to T5 were significantly higher in the COM Group than in the MOR Group (p < 0.05). The postoperative morphine dose and the incidence of postoperative itching, nausea, and vomiting were significantly lower in the COM Group than in the MOR Group (p < 0.05).

Conclusions

Dexmedetomidine combined with morphine for post‐thoracotomy PCIA can improve the function of immunocytes, reduce morphine consumption, and reduce the adverse reactions during analgesia induction.