超声引导下单次竖脊肌平面阻滞对达芬奇辅助胸腔镜肺叶切除患者镇痛、炎性及免疫指标的影响

doi:10.3969/j.issn.1671-7171.2021.04.010

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Abstract 【Objective】 To investigate the analgesic effect of single erector spinae plane (ESP) block under ultrasound-guided Da Vinci robotic surgery for patients undergoing lower lobectomy and its effect on inflammatory factors and immune function. 【Methods】 A total of 80 patients who underwent Da Vinci robotic surgery for lower lobectomy was divided into an observation group and a control group, with 40 people in each group by the random number table method. The observation group underwent single ultrasound-guided ESP block before anesthesia induction, and the control group received ultrasound-guided paravertebral nerve block (TPVB) before anesthesia induction.The two groups used patient-controlled intravenous analgesia (PCIA) after operation.The visual simulation method (VAS) was used to evaluate pain score in the rest and cough at the time of extubation (T₁), 6h after surgery (T₂), 18h after surgery (T₃), 24h after surgery (T₄) and 48h after surgery (T₅).The number of patients getting out of bed cases within 24 hours and the number of PCIA compress-ions within 48 hours after operation were counted.The fasting venous blood of the patients was collected in the morning 24 hours after operation, and the inflammatory factors (IL-6, IL-8, CRP, TNF-α) and immune function indicators (IgG,IgA,IgM) were detected by Enzyme-Linked Immunosorbent Assays (ELISA). 【Results】 Patients in the observation group had lower pain scores in the resting and cough during extubation (T₁), 6h (T₂), 18h (T₃), 24h (T₄) and 48h (T₅) after surgery(P<0.05).The rate of getting out of bed cases in the observation group was 82.5%, which was higher than that in the control group 62.5%. The difference between the two groups was statistically significant (P<0.05).The number of PCIA compressions in the observation group was lower than that in the control group (P<0.05).The levels of inflammatory factors IL-6, IL-8, CRP, and TNF-α in the observation group were lower than those in the control group (P<0.05).The serum IgG, IgA and IgM immune indexes of observation group were higher than those of control group at 24h after operation (P<0.05). 【Conclusion】 Robot-assisted thoracoscopic lobectomy patients with ultrasound-guided single ESPB have better analgesic effects than TPVB, and postoperative inflammation symptoms are mild, indicating that ESPB has stronger immune function compared with TPVB.

Key words： Neuromuscular Blockade Ultrasonography Robotic Surgical Procedures Thoracoscopy Pneumonectomy/MT Analgesia

Received: 16 October 2020

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R734.2

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	ZHANG Qun-qing
	XU Xiang-zhao
	LI Jing
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ZHANG Qun-qing,XU Xiang-zhao,LI Jing, et al. Effect of Ultrasound-guided Single Erector Spinalis Plane Block on Analgesia, Inflammatory and Immune Indexes of Pulmonary Lobectomy Under Da Vinci Operation[J]. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 515-518.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.04.010 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I4/515

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