Objective To observe the effect of acupoint injection of Lidocaine on serum IL-1β

TNF-αand T-lymphocyte subset activities in patients undergoing laparoscopic cholecystectomy(LC)

so as to reveal its mechanisms underlying relieving postoperative pain and potentiating rehabilitation.Methods Eighty patients scheduled for elective LC surgery(grade I or II

according to American Standards of Association

ASA)were randomly divided into four groups

namely intravenous analgesia(IVA)

right forearm-injection(forearm-I)

Jiaji(EX-B 2

Thorax 8)-injection(EX-B 2-I)

and Zusanli-injection(ST 36-I)

with20 patients in each group.The conventional anesthetic induction and maintenance with Penehyclidine Hydrochloride

Midazolam

Sulfentanil

Propofol

Atracurium Besilate

and Remifentanil were same in all the 4groups.For patients of the forearm-I

EX-B 2-I and ST 36-I groups

5% Lidocaine was injected into the subcutaneous layer of the anterior side of right forearm near the elbow

EX-B 2and ST 36 regions

respectively.Analgesia pump(filled with Sulfentanil

Ramosetron+normal saline)was connected after the tracheal extubation.The visual analog scale(VAS)was used to assess the patient's pain reaction after tracheal extubation(T 1)

and 6h(T 2)

24h(T 3)and 48h(T 4)after surgery.The times of PCA pressing and the total dose of Sufentanil in the process of postoperative analgesia were recorded as well.The contents of serum IL-1βand TNF-αwere analyzed by ELISA

and the counts of CD4+and CD8+T cells were detected by flow cytometry.Results Compared with T 1in the same one group

the VAS scores at time-points of T 2

T 3and T 4after surgery of all the IVA

forearm-I

ST 36-I and EX-B 2-I groups were reduced significantly(P<0.05).The times of PCA pump pressing and the doses of the administrated Sufentanil were considerably lower in the ST 36-I and EX-B 2-I groups than in the IVA and forearm-I groups(P<0.05).In comparison with pre-anesthesia in the same one group

serum TNF-αand IL-1βcontents at T 1were remarkably increased

while the ratios of CD4+/CD8+at T 4in the 4groups were evidently down-regulated(P<0.05).The contents of serum TNF-αand IL-1βat T 3and T 4were obviously lower in both ST 36-I and EX-B 2-I groups than in the IVA and forearm-Ⅰ groups(P<0.05).No significant differences were found among the 4groups in the VAS scores at the 4time-points

in the serum TNF-αand IL-1βcontents at T 0and T 1

in the counts of CD4+and CD8+T cells and ratios of CD4+/CD8+at T 0

T 3and T 4

and between the ST 36-I and EX-B 2-I groups in all the 8indexes(P>0.05).Conclusion Acupoint injection of Lidocaine is effective in relieving pain in LC patients

which is demonstrated by reducing VAS score

PCA pump pressing times

and administrated Sufentanil dose

and may be associated with its effects in down-regulating serum TNF-αand IL-1βcontents.