Abstract: Objective The aim of this study was to investigate patient controlled epidural analgesia (CEA) in patients with hepatolithiasis after laparoscopic hepatectomy (LH). Methods A total of 78 patients with hepatolithiasis were encountered in our hospital between January 2020 and July 2024, and all underwent LH. On support of induction and maintenance anesthesia, the operation was finished. After completion of surgery, patients were assigned to receive CEA (n=40) or patient controlled intravenous analgesia (CIA, n=38) for post-operational analgesia. Numerical rating scale (NRS) was evaluated, serum interleukin (IL)-6, IL-8 and IL-10 levels were detected by ELISA, and serum cortisol (Cor), adrenocorticotropic hormore (ACTH) and malondialdehyde (MDA) levels were assayed by ELISA. Results At 6 h, 12 h, 24 h and 48 h after surgery, dynamic NRS scores in CEA group were(3.8±1.2), (3.5±1.), (3.1±0.9) and (2.5±0.7), all significantly lower than(4.1±1.2), (4.4±1.2), (3.9±1.0) and (3.2±0.8), respectively, ,P＜0.05] in CIA group; within 48 h since termination of operation, total compression on analgesic pumps in CEA group was(8.5±2.2)times, and effective compression was o(7.3±1.7)times, both much less than [(10.7±3.4)times and (10.0±2.2)times, respectively, P＜0.05] in CIA group; serum IL-6 and IL-8 levels in CEA group were (26.4±4.9)ng/ml and (25.5±5.4)ng/ml, both significantly lower than [(42.6±5.2)ng/ml and (35.1±5.6)ng/ml, respectively, P＜0.05], while serum IL-10 level was (44.1±3.9)pg/ml, much higher than [(27.6±4.0)pg/ml, P＜0.05] in CIA group; serum Cor, ACTH and MDA levels in CEA group were (318.5±58.3)mmol/L, (19.6±4.3)pmol/L and (3.4±0.8)mmol/mL, all significantly lower than [(375.9±66.4)mmol/L, (25.9±5.6)pmol/L and (4.3±1.0)mmol/mL, respectively, P＜0.05] in CIA group. Conclusion CEA has a satisfactory analgesic effect in patients with hepatolithiasis after LH, which might be related to inhibition of stress inflammatory reactions, with less cytokine secretion.

Key words: Hepatolithiasis, Laparoscopic hepatectomy, Patient controlled epidural analgesia, Patient controlled intravenous analgesia, Analgesia