Abstract:【Objective】To investigate the effects of serratus anterior plane block (SAPB) combined with general anesthesia on serum C-reactive protein (CRP),interleukin-6 (IL-6) and procalcitonin (PCT) levels in elderly patients undergoing upper abdominal surgery. 【Methods】A total of 78 elderly patients who were selected for upper abdominal surgery were randomly divided into the observation group and the control group.The patients in the control group received general anesthesia,while patients in the observation group received low SAPB combined general anesthesia under ultrasound guidance 30 minutes before operation.The perioperative indexes of the two groups were observed and compared,and the visual analogue score (VAS) scores of pain at rest and during cough of patients in the two groups at the time of extubation (T0),4 hours after operation (T1),8 hours after operation (T2),12 hours after operation (T3),and 24 hours after operation (T4) were recorded and compared.The dosage of propofol and remifentanil during operation,the number of analgesic pumps used 24 hours after operation,and the total amount of background infusion were recorded and compared between the two groups.The levels of CRP,IL-6 and PCT were compared between the two groups before operation,1 day after operation and 2 days after operation.The adverse reactions of the two groups were compared as well. 【Results】There was no significant difference between the observation group and the control group in terms of recovery time,extubation time and length of hospitalization (P>0.05).The first time of getting out of bed in the observation group was significantly shorter than that in the control group (P<0.05).At T0,there was no significant difference in VAS scores between the two groups at rest and during cough (P>0.05).The VAS pain scores at T1-T4 in the observation group at rest and during cough were significantly lower than those in the control group (P<0.05).The amount of propofol and remifentanil used during operation,the number of times of pressing analgesia pump 24 hours after operation,and the total amount of background infusion in the observation group were significantly lower than those in the control group (P<0.05).The levels of CRP,IL-6 and PCT in the observation group were significantly lower than those in the control group 1 day and 2 days after operation (P<0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). 【Conclusion】Compared to general anesthesia,SAPB combined with general anesthesia has a better postoperative analgesic effect on elderly upper abdominal patients.It has less impact on serum CRP,IL-6 and PCT levels,so it can reduce inflammatory reaction and has fewer adverse reactions,which is worthy of clinical application and promotion.
李争卫, 邓挚玺. 低位SAPB联合全身麻醉对老年上腹部手术患者术后血清CRP、IL-6、PCT水平的影响[J]. 医学临床研究, 2022, 39(11): 1640-1643.
LI Zheng-wei, DENG Zhi-xi. Effect of Low SAPB Combined with General Anesthesia on Serum CRP,IL-6 and PCT Levels in Elderly Patients undergoing Upper Abdominal Surgery. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1640-1643.
[1] WATSON E,COBDEN E J,VASEY C E.A pilot randomised controlled trial of patient education to improve umbilical cleanliness prior to laparoscopic surgery[J].ANZ J Surg,2021,91(12):2650-2655. [2] ABDALLAH F W,PATEL V,MADJDPOUR C,et al.Quality of recovery scores in deep serratus anterior plane block vs.sham block in ambulatory breast cancer surgery:a randomised controlled trial[J].Anaesthesia,2021,76(9):1190-1197. [3] GANGULY M,NANDI A,BANERJEE P,et al.A comparative study of IL-6,CRP and NT-proBNP levels in post-COVID multisystem inflammatory syndrome in children (MISC) and Kawasaki disease patients[J].Int J Rheum Dis,2022,25(1):27-31. [4] 王永徽,刘广林,董海龙,等.超声引导下三点阻滞与椎旁阻滞用于剖腹肝胆手术术后镇痛的比较[J].临床麻醉学杂志,2020,36(5):421-424. [5] 林建宏,刘晓飞,王倩,等.超声引导下不同浓度吗啡复合罗哌卡因前锯肌平面阻滞对乳腺癌患者术后镇痛效果的影响[J].山东医药,2020,60(23):70-72. [6] ZOU S H,ZHANG L F,CHEN Q L,et al.The prognostic value of serum PCT,hs-CRP,and IL-6 in patients with sepsis[J].Open Life Sci,2017,12(1):425-428. [7] 张隆盛,张楷弘,杨铎,等.老年胸腔镜术后连续前锯肌平面阻滞与胸椎旁阻滞镇痛效果比较[J].实用医学杂志,2021,37(5):654-659. [8] 施伍,贾欣,梁悦,等.蓝斑介导右美的镇痛镇静作用的神经机制研究[J].安徽医科大学学报,2020,55(6):831-836. [9] 李曰平,凌宗准,田晓卫,等.生长抑素联合红霉素对腹部损伤患者术后胃肠功能、免疫及炎症因子的影响[J].中国现代医学杂志,2020,30(17):62-66. [10] 王晓亚,陈井丽,何留品,等.血清β-hCG、PCT、CRP和GBS对胎膜早破妇女宫内感染的预测效果研究[J].现代预防医学,2020,47(4):698-701. [11] 张欣,申乐,黄宇光.丝裂原活化蛋白激酶在糖尿病神经病理性疼痛中枢敏化和外周敏化中作用的研究进展[J].中国医学科学院学报,2019,41(1):118-123.