胸椎旁神经阻滞联合全麻对腔镜下肺癌根治术后患者细胞免疫及疼痛的影响

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Abstract Objective To investigate the effect of ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia on postoperative cellular immunity and pain in patients undergoing endoscopic radical resection of lung cancer.Methods A total of 60 patients with lung cancer admitted to Jiangxi Provincial People′s Hospital from June 2018 to October 2020 were selected as the research subjects,and divided into group P(30 cases)and group C(30 cases)according to random number table method.Group C received general anesthesia,and group P received thoracic paravertebral nerve block combined with general anesthesia.T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+),intraoperative amounts of remifentanil and propofol,and visual analog scale(VAS)scores at cough at 2,6,12,24 and 36 h after surgery,at 12,24,48 h postoperative intravenous analgesia pump pressure frequency and postoperative relief analgesia rate were compared between the two groups.Results There were no significant differences in the levels of T lymphocyte subsets before and 48 h after operation between the two groups(P＞0.05).CD3+,CD4+and CD4+/CD8+in group P were higher than those in group C after operation and 24 h after operation,the differences were statistically significant(P＜0.05).The dosage of Remifentanil and Propofol in group P were lower than those in group C,and the differences were statistically significant(P＜0.05).The VAS score of cough in group P were lower than those in group C at 2,6 and 12 h after operation,and the differences were statistically significant(P＜0.05).At 12,24 h after surgery,the frequency of automatic pump pressing in group P were less than those in group C,and the remedial analgesia rate in group P was lower than that in group C,the differences were statistically significant(P＜0.05).Conclusion Thoracic paravertebral nerve block combined with general anesthesia in patients with thoracoscopic radical resection of lung cancer can provide satisfactory intraoperative and postoperative analgesic effects,reduce the usage amount of general anesthesia,and improve the cellular immune function of patients after surgery,which is worthy of clinical promotion and application.

Key words： Thoracic paraspinal nerve block General anesthesia Radical resection of lung cancer Cellular immunity Pain Visual analogue scale

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	Articles by authors
	GUO Shan-liang
	SU Hua-feng
	LIU Yan-long
	FAN Long-cheng
	KUANG Song-tao
	ZHANG Ming-sheng

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GUO Shan-liang,SU Hua-feng,LIU Yan-long, et al. Effect of thoracic paravertebral nerve block combined with general anesthesia on cellular immunity and pain in patients undergoing endoscopic radical resection of lung cancer[J]. 中国当代医药, 2021, 28(17): 8-11转19.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I17/8

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