beta-endorphin and Esophageal-Neoplasms

To examine the analgesic effect of preoperative administration of flurbiprofen axetil and that of postoperative administration of a combination of flurbiprofen axetil and fentanyl, as well as perioperative plasma β-endorphin (β-EP) levels in patients undergoing esophagectomy.. Forty-five patients were randomly divided into three groups: group A: 100 mg flurbiprofen axetil preoperative, 10 μg/kg fentanyl + 10 ml placebo postoperative; group B: 100 mg flurbiprofen axetil preoperative, 10 μg/kg fentanyl + 100 mg flurbiprofen axetil postoperative; group C: 10 ml placebo preoperative, 10 μg/kg fentanyl + 10 ml placebo postoperative. Postoperative analgesia was achieved by intravenous infusion containing flurbiprofen axetil and/or fentanyl at 2.0 ml/h (total volume, 100 ml) using infusion pumps. The β-EP was measured at preanesthesia (T(1)), the end of surgery (T(2)), 24 h (T(3)), and 48 h (T(4)) after surgery. Visual analog scale scores (VAS) at T3, T4 (at rest), and rescue analgesic tramadol requirement was recorded.. The VAS of group B was significantly lower than group A and C (P < 0.01) at T(3) and T(4). The β-EP levels at T(2)-T(4) in group A did not differ significantly from those at T(1) (P > 0.05); however, the β-EP levels in group B at T(3)-T(4) increased significantly (P < 0.05), while those in group C increased at T(2) and decreased at T(4) (P < 0.05). The β-EP levels in group B at T(3) and T(4) were the highest as compared to its levels in groups A and C (P < 0.01). Tramadol consumption in group B was significantly lower than in groups A and C (P < 0.01).. These results show that flurbiprofen axetil enhances the analgesic effect of fentanyl associated with increase in β-EP levels.

Topics: Analgesia; Analgesics, Opioid; Anti-Inflammatory Agents, Non-Steroidal; beta-Endorphin; Drug Synergism; Drug Therapy, Combination; Esophageal Neoplasms; Esophagectomy; Female; Fentanyl; Flurbiprofen; Humans; Male; Middle Aged; Pain, Postoperative; Placebos; Preoperative Care

To evaluate the effects of patient-controlled analgesia (PCA) with small dose ketamine combined with morphine on analgesia and influence thereof on the plasma beta-endorphin (EP) level in the patients after radical operation for esophageal carcinoma.. Thirty ASAI-II patients, aged 35-65, weighing 42-75 kg, with visual analogue score>or=3, undergoing elective radical operation for esophageal carcinoma under general anesthesia received intravenous morphine 2 - 3 mg were randomly divided into 2 equal groups: group m receiving morphine 0.02 mg.kg(-1).h(-1), and with group mk receiving morphine 0.02 mg.kg(-1).h(-1) combined with ketamine 0.08 mg.kg(-1).h(-1) for 50 h. In the course of treatment the patients received intravenous injection of morphine 2-3 mg when the VAS was >or=3. VAS was recorded 4, 8, 20, 24, and 48 h after operation. The amount of morphine used after operation, PCA button pressing times (effective/active), side effects, and vital signs including pulse, saturation of blood oxygen, respiratory rate, heart rate, and average arterial pressure were recorded. Central venous blood samples were collected when entering the operation room (T0), by the end of operation (T1), and 6 h (T2), 24 h (T3), and 48 h (T4) after operation respectively to examine the beta-endorphin level.. During the period 4-48 h after operation the VAS scores of the group mk were significantly lower than those of the group m in activity state (all P<0.05) and were not significantly different those of the group m at resting state (all P>0.05). The total amount of morphine consumed and the actual PCA button pressing times were significantly less in the group mk than in the group m (both P<0.05). The incidence rates of nausea, vomiting, and pruritus of the group mk were all significantly lower than those of the group m (all P<0.05). There were not significant differences in the incidence rates of dreaming and pseudoesthesia between these 2 groups. All the vital signs were stable in the 2 groups. The plasma beta-EP levels at the time point T1 of these 2 groups were both significantly higher than those at T0 (both P<0.05). The plasma beta-endorphin levels at T2-4 of the group mk decreased gradually from the level at T1 to the level at T0, and the plasma beta-endorphin levels of the group m rapidly decreased from the level at T0 to the T0 level and remained at this level to the 48 h after operation.. The combination of small dose of ketamine with morphine provides optimal analgesia with low side-effect rate and little effect on the plasma beta-EP level.

Topics: Adult; Aged; Analgesia, Patient-Controlled; beta-Endorphin; Esophageal Neoplasms; Female; Humans; Ketamine; Male; Middle Aged; Morphine; Pain, Postoperative; Treatment Outcome

In order to investigate the role of acupuncture in the regulation of cellular immune function, the changes of T lymphocyte subsets (CD3+, CD4+, CD8+), soluble interleukin-2 receptor (SIL-2 R) and beta-endorphine (beta-EP) in the peripheral blood of patients with malignant tumors before and after acupuncture were observed with double blind method. Forty patients were divided randomly into two groups, 20 for each. One group treated with acupuncture and the other one for control. Results showed that acupuncture has the effect of enhancing the cellular immunity of patient with malignant tumor. Acupuncture treatment could increase the percentage of T lymphocyte subsets CD3+, CD4+ and the CD4+/CD8+ ratio (P < 0.01) and the level of beta-EP, as well as decrease the level of SIL-2 R (P < 0.01). The correlation analysis of the three criteria showed there was a positive correlation between beta-EP and T lymphocyte subsets and a negative correlation between beta-EP and SIL-2 R, there was also a negative correlation between T lymphocyte subsets and SIL-2 R. Based on these results, a discussion on the acupuncture immunomodulation network was conducted in this article in order to explore the possible mechanism of acupuncture on immunomodulation.

Topics: Acupuncture Therapy; Adult; Aged; beta-Endorphin; CD4-CD8 Ratio; Double-Blind Method; Esophageal Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Receptors, Interleukin-2; T-Lymphocyte Subsets

In order to investigate the role of acupuncture in the regulation of cellular immune function, we observed acupuncture therapy affecting the levels of T lymphocytes subgroup (CD3+, CD4+, CD8+), soluble interleukin-2 receptor (SIL-2R) and beta-endorphin (beta-EP) in the peripheral blood of patients with malignant tumors. Here was used the random-gioland method, the patients were divided into a group treated by acupuncture (acup. group, 20 cases) and a control group (20 cases). The acup. group was treated using points PC6, LI4, ST36, RN4 and location of symptomatic points bilaterally, one treatment of 30 min daily for 10 days. The results showed that there were increased levels of CD3+, CD4+ percentage, CD4+/CD8+ ratio and radioimmunoassay of beta-EP in blood plasma, a decreased level of SIL-2R after acup. The statistical significance was found to be remarkable (P < 0.01), so has a notable difference, the correlation analysis indicated: (1) there was a positive correlation between beta-EP and T-lymphocytes subgroups; (2) a negative correlation between beta-Bp and SIL-2R, so did it between T subgroups and SIL-2R. Our results showed that beta-EP enhanced immune function of patients by increased T lymphocyte subgroups, reduced SIL-2R, and this action of beta-EP may be mediated by opioid receptor. The above mentioned results prevented evidence that there was an adjusting-network of immune in the body, through this way, acup. therapy can heighten the cellular immune function of patients, providing a beneficial effect in anti-cancer treatment.

Topics: Acupuncture Therapy; Adult; Aged; beta-Endorphin; CD4-CD8 Ratio; Esophageal Neoplasms; Female; Humans; Immunity, Cellular; Lung Neoplasms; Male; Middle Aged; Receptors, Interleukin-2; T-Lymphocyte Subsets

To discuss the clinical therapeutic effects of electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) on the analgesic effect of thoracic perioperative stage and its effect mechanism.. Sixty cases of esophageal cancer with elective radical resection under general anesthesia were divided into an observation group and a control group according to the operation sequence, 30 cases in each one. In the control group, the general anesthesia was simply applied and sufentanil was administered for patient controlled intravenous analgesia (PCIA) after operation. In the observation group, on the basis of the scheme as the control group, the electroacupuncture was used at Neimadian (Extra) and Neiguan (PC 6) 30 min before anesthesia induction and after operation, with continuous wave, tolerable intensity, lasting for 30 min. Separately, before acupuncture (T1) and 2h (T2), 12h (T3), 24h (T4) and 48h (T5) after operation, the plasma β-endorphin (β-EP), 5-hydroxytryptamine (5-HT) and prostaglandin E. ①The total dosage of sufentanil in the observation group was less than that in the control group[(1.83±0.56) mg vs (2.54±0.62) mg,. Electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) provides the safe and effective postoperative anesthesia of thoracic surgery and reduces the dosage of analgesics during the operation, which is possibly related to the increase of endogenous β-EP and the inhibition on the release of 5-HT and PGE

Topics: Acupuncture Analgesia; Acupuncture Points; Anesthesia, General; Anesthetics, Intravenous; beta-Endorphin; Biomedical Research; Case-Control Studies; Dinoprostone; Electroacupuncture; Esophageal Neoplasms; Humans; Pain Management; Pain Measurement; Serotonin; Sufentanil