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

doi:10.3969/j.issn.1671-7171.2022.11.012

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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.

Key words： Neuromuscular Blockade Anesthesia Abdomen/SU C-Reactive Protein Aged

Received: 24 May 2022

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R656

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	LI Zheng-wei
	DENG Zhi-xi

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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[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1640-1643.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2022.11.012 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2022/V39/I11/1640

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