Application of ultrasound-guided stellate ganglion block after operation in perioperative period of thyroid cancer patients / 中国医师进修杂志

ABSTRACT

Objective:To explore the application value of ultrasound-guided stellate ganglion block in perioperative period of thyroid cancer patients.Methods:From March 2018 to November 2019, in the Second People′s Hospital of Lu′an, Anhui Province, the clinical data of 80 thyroid cancer patients who had underwent open radical operation were retrospectively analyzed. Among them, ultrasound-guided stellate ganglion block was performed in 40 cases (observation group), while ultrasound-guided stellate ganglion block was not performed in 40 cases (control group). The pain digital score (NRS) 6, 12 and 24 h after operation was evaluated. The levels of inflammatory factors, including tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) 24 h after operation were detected. The indexes of cellular immune function (CD 4+, CD 8+ and CD 4+/CD 8+) 24 h after operation, serum parathyroid hormone (PTH) before operation and 48 h after operation were detected. The postoperative complication was observed. Results:The NRS 6, 12 and 24 h after operation in observation group were significantly lower than that in control group (3.6 ± 0.3) scores vs. (4.3 ± 0.4) scores, (2.1 ± 0.2) scores vs. (3.5 ± 0.3) scores and (2.6 ± 0.2) scores vs. (3.6 ± 0.3) scores, and there was statistical difference ( P<0.01). The TNF-α, hs-CRP and IL-6 24 h after operation in observation group were significantly lower than those in control group (85.9 ± 6.8) μg/L vs. (263.5 ± 13.7) μg/L, (6.1 ± 1.6) mg/L vs. (12.3 ± 2.5) mg/L and (236.9 ± 8.6) μg/L vs. (388.9 ± 15.5) μg/L, the CD 4+, CD 8+ and CD 4+/CD 8+ were significantly higher than those in control group 0.036 ± 0.013 vs. 0.024 ± 0.010, 0.034 ± 0.013 vs. 0.026 ± 0.009 and 1.9 ± 0.1 vs. 1.4 ± 0.1, and there were statistical differences ( P<0.01). There was no statistical difference in PTH before operation between 2 groups ( P>0.05); the PTH 48 h after operation in observation group was significantly higher than that in control group (29.8 ± 3.9) μg/L vs. (18.7 ± 2.0) μg/L, and there was statistical difference ( P<0.01). The incidence of postoperative complication in observation group was significantly lower than those in control group 5.0% (2/40) vs. 25.0% (10/40), and there was statistical difference ( χ2 = 4.804, P<0.05). Conclusions:Ultrasound-guided right stellate ganglion block can effectively relieve postoperative pain, reduce inflammatory reaction, improve immunity, promote the recovery of parathyroid function, and reduce the incidence of postoperative complication in patients with thyroid cancer.