胸椎旁神经阻滞复合全麻对肝癌切除术患者术后镇痛效果、 炎症应激反应和免疫功能的影响.

Objective: To investigate the analgesic effect of thoracic paravertebral nerve block (TPVB) combined with general anesthesia in liver cancer resection. Methods: 120 patients undergoing liver cancer resection were divided into a control group and a TPVB group based on different anesthesia methods, with 60 patients in each group. The control group received simple general anesthesia, and the TPVB group received TPVB combined with general anesthesia. The pain numerical rating scale (NRS) scores of the two groups were recorded at 4 h, 12 h, 24 h and 48 h after operation. The use of anesthetic drugs and postoperative analgesia related indicators in the two groups were recorded. The adverse reactions, first exhaust time and hospitalization time of the two groups were recorded. The serum levels of interleukin-6 (IL-6) and IL-8 were detected before and 24 hours after operation, and the peripheral blood T lymphocyte subsets were measured by flow cytometry. Results: Compared with the control group, the NRS scores of the TPVB group at 4 h, 12 h and 24 h after operation were significantly decreased (P<0.05). Compared with the control group, the amount of remifentanil used in the TPVB group was reduced (P<0.05), the time of first pressing the analgesic pump was delayed (P<0.05), the number and amount of analgesic pressing at 24 h after operation were reduced (P<0.05), and the remedial analgesia rate was significantly reduced (P<0.05). The first exhaust time in the TPVB group was earlier than that in the control group (P<0.05), the hospitalization time was shorter than that in the control group (P<0.05), and the incidence of postoperative nausea and vomiting was significantly lower than that in the control group (P<0.05). At 24 h after operation, the levels of IL-6 and IL-8 in the two groups were higher than those before operation (P<0.05), but the TPVB group was lower than the control group (P<0.05). At 24 h after operation, the levels of CD3+, CD4+ and CD4+ /CD8+ in the two groups were lower than those before operation (P<0.05), but those in the TPVB group were higher than those in the control group (P<0. 05). Conclusion: TPVB combined with general anesthesia for liver cancer resection can improve postoperative analgesia, reduce perioperative opioid consumption, reduce postoperative inflammatory response, improve postoperative immune function, and have a positive effect on postoperative recovery. [ABSTRACT FROM AUTHOR]