全身麻醉联合超声引导下椎旁神经阻滞用于食管癌胸腹腔镜手术中的价值

doi:10.3969/j.issn.1671-7171.2024.10.029

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Abstract 【Objective】 To investigate the value of general anesthesia combined with ultrasound-guided paravertebral nerve block (USG-PVB) in thoracic laparoscopic surgery for esophageal cancer. 【Methods】 A total of 86 patients who underwent thoracic laparoscopic surgery for esophageal cancer were randomly divided into the observation group and the control group, 43 cases in each group. Both groups underwent thoracic laparoscopic surgery, the control group was given general anesthesia, and the observation group was given general anesthesia combined with USG-PVB anesthesia. Intraoperative drug dosage and perioperative indexes were compared between the two groups. At 4 h(T₁), 24 h(T₂) and 48 h(T₃), restlessness was assessed by Ricker sedation-agitation score (SAS) and pain was assessed by visual analog scale (VAS). The levels of immune function [CD3⁺, CD4⁺, natural killer cells (NK)] were compared between the two groups at different time points. The incidence of complications was compared between the two groups. 【Results】The intraoperative dosage of propofol, remifentanil and sufentanil in the observation group was significantly lower than that in the control group (P<0.05), and the dosage of deoxyadrenaline was significantly higher than that in the control group (P<0.05). There was no statistical significance in the dosage of ephedrine and nicadipine between two groups (P>0.05). The extubation time, waking time and postoperative hospitalization time in the observation group were significantly shorter than those in the control group (P<0.05), and there was no statistical significance in the operation time between the two groups (P>0.05). The SAS and VAS scores of the observation group at T₁, T₂ and T₃ were significantly lower than those of the control group (P<0.05). The levels of CD3⁺, CD4⁺ and NK were significantly higher than those of the control group (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). 【Conclusion】The application of general anesthesia combined with USG-PVB anesthesia in thoracic laparoscopic surgery for esophageal cancer can effectively reduce the use of intraoperative drugs, which is conducive to postoperative recovery of patients, and can alleviate postoperative agitation and pain of patients, with little impact on immune function and fewer complications, which is worthy of clinical promotion and application.

Key words： Esophageal Neoplasms/SU Anesthesia, General Thoracoscopy Laparoscopy Nerve Block

Received: 16 August 2023

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R735.1

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	Articles by authors
	ZHE Tiantian
	TIAN Longfei
	SUN Yifei

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ZHE Tiantian,TIAN Longfei,SUN Yifei. Value of General Anesthesia Combined with Ultrasound-guided Paravertebral Nerve Block in Thoracic Laparoscopic Surgery for Esophageal Cancer[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1557-1560.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.10.029 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I10/1557

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