超声引导下胸椎旁神经阻滞对单孔胸腔镜术后患者镇痛和细胞免疫的影响

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Abstract Objective To explore the effect of ultrasound-guided thoracic paravertebral block (TPVB) on analgesic and cellular immune function in patients with video-assisted single-hole thoracic surgery. Methods A total of 60 patients who underwent selective single-port thoracoscopic partial pneumonectomy in Wuxi Huishan District People′s Hospital from March to August 2020 were selected as the research subjects. According to random number table method, they were divided into TPVB group and control group, with 30 patients in each group. In TPVB group, T4-5, T6-7 thoracic paravertebral nerve block was performed under ultrasonic guidance after intubation induced by general anesthesia. After confirming that there was no blood, no gas, and no cerebrospinal fluid, 10 mL 0.5% ropivacaine was injected, respectively. In the control group, 10 mL of normal saline was injected into the same thoracic paravertebral space. The number of sufentanil and methydroxyamine additions during surgery, visual analogue scale (VAS) scores 24 and 48 h after surgery, the number of effective pressure on patient controlled intravenous analgesia (PCIA), and the changes of CD4+,CD8+and CD3+before and 24 and 48 h after anesthesia induction were compared between the two groups. Results The number of intraoperative sufentanil and hydroxyamine supplementation in TPVB group was less than that in control group, the difference was statistically significant (P<0.05). 24 and 48 h after surgery, the VAS scores of TVPB group were lower than the control group, and the effective times of PCIA compression were less than the control group, the differences were statistically significant (P<0.05). There was no significant difference in the levels of CD4+, CD8+ and CD3+ between the two groups before anesthesia induction (P>0.05). 24 h after operation, CD4+, CD8+, CD3+ levels in TPVB group were higher than those in control group, 48 h after operation, CD8+ and CD3+ levels in TPVB group were higher than those in control group, the differences were statistically significant (P<0.05). Conclusions Ultrasound-guided thoracic paravertebral nerve block can not only improve the effect of analgesia, but also maintain the T-lymphocyte subgroup level and reduce the inhibition of cellular immunity of patients with uniportal video-assisted thoracoscopic surgery.

Key words： Ultrasound-guided Thoracic paravertebal block;Video-assisted thoracoscopic surgery Cellular immune function

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NI Xin-xin. Effect of ultrasound-guided thoracic paravertebral block on analgesic and cellular immune function in patients with video-assisted single-hole thoracic surgery[J]. 中国当代医药, 2021, 28(21): 156-159.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I21/156

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