Author(s): Haixia Shi*
Background and aim: Open colectomy is associated with postsurgical pain. Regulatory T cells (Tregs) are crucial in the recovery and metastasis of tumor cells, infection and immune response. To compare the expression of Tregs on Patient-Controlled Epidural Analgesia (PCEA) and Patient-Controlled Intravenous Analgesia (PCIA) in elderly patients undergoing open colectomy.
Methods: From September 2015 to October 2017, 100 elderly patients were scheduled for elective open colectomy with general anesthesia. Patients were randomly divided into the PCEA and PCIA group. Detected CD4, CD25 and CD27 by flow cytometry and calculated the proportion of CD4+ CD25+ CD127- Tregs in CD4+ T lymphocytes. Recorded Visual Analog Pain Score (VAS) on the first and second days postoperatively. Also, recorded adverse drug events, such as dizzy, respiratory suppression, nausea and vomit, itchy skin, sensory or motor block.
Results: Compared with the baseline before the surgery, the proportion of Tregs showed increased significantly in both groups on the first day after the surgery (P<0.05). On the first day after surgery, the proportion in the PCEA group (2.86% ± 0.73%) was significantly lower than that in the PCIA group (3.78% ± 0.87%) (P<0.05). VAS in the PCEA group was considerably lower than that in the PCIA group during 48 hours after the surgery (P<0.05). There was no significant difference in adverse drug events between groups (P>0.05).
Conclusion: Compared with PCIA, PCEA can reduce Tregs expression in elderly patients undergoing open colectomy on the first day after surgery, decreased postoperative pain during 48 hours and without significant adverse events.
