Рівень Toll – пдібних рецепторів у плазмі – маркер гіпералгезії в ранньому післяопераційному періоді

Відомо, що при активації TLR4 моноцитів/макрофагів, окрім прозапальних цитокінів, виникає вихід опіоїдних пептидів з останніх. В статі показано що у 24 дітей прооперованих с приводу пухлин черевної порожнини використання високих доз фентанілу для знеболення в ранньому післяопераційному періоді може призводити до гіпералгезії. Гіпералгезія в ранньому післяопераційному періоді репрезентувалася підвищенням TLR4.It is well-known that at activation of TLR4 monocytes/macrophages takes place an escape of opioid peptides from inflammatory cytokines that is one of the more important mechanisms of antinociceptive system. Materials and method. In 24 children who underwent operations of abdominal cavity tumors were done 20 measurements of the mechanical pain threshold using the set of 10 von Frey monofilaments (VFM). The pain threshold was measured on the surface around postsurgical wound. The content of tall-like receptors TLR-4 in the blood serum was detected by immunoenzyme method using “Human TLR4 ELISA Kit” (NeoBiolab, USA) set. Results. The use of big doses of fentanyl (2800–6200 mcg/day) for anesthesia in early postoperative period in children may lead to hyperalgesia. Hyperalgesia in an early postoperative period is characterized with an increase of TLR4 in blood (at 3 day the level of TLR4 was 14,2±2,4, ng/ml, at 5 day – 12,1±1,6, ng/ml that is significantly higher than preoperative its level – 5,2±1,4, ng/ml). Conclusions. The big doses of fentanyl were associated with lowered pain threshold and development of hyperalgesia that was represented with an increase of TLR4 level in blood of children who underwent operations of abdominal cavity tumors. An analysis of graphic dependency of distribution of outgoing remains from prognosticated values and its diagram reproduction testified that it have chaotic character of disposition on the plane and there was not observed any regularity in its behavior that testifies an absence of correlations between it