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Effect of erector spinae plane block combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing thoracoscopic radical resection of lung cancer / 中华麻醉学杂志
Chinese Journal of Anesthesiology ; (12): 266-269, 2021.
Article in Chinese | WPRIM | ID: wpr-911180
ABSTRACT

Objective:

To evaluate the effect of erector spinae plane (ESP) block combined with general anesthesia on early postoperative cognitive function in elderly patients undergoing thoracoscopic radical resection of lung cancer.

Methods:

Sixty patients of both sexes, aged ≥65 yr, with body mass index< 30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for single-port thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=30 each) using a random number table

method:

ESP block plus general anesthesia group (group ESP+ GA) and general anesthesia group (group GA). Ultrasound-guided ESP was performed at T 4 before induction of general anesthesia in group ESP+ GA.The success of the nerve block was determined by pin-prick test at 20 min after nerve block, and then anesthesia was induced.Anesthesia was maintained with propofol plus remifentanil in the two groups.Patient-controlled intravenous analgesia was performed.Venous blood samples were collected at 1 day before operation and 1, 2 and 3 days after operation for determination of plasma S100β protein and neuron-specific enolase (NSE) concentrations by enzyme-linked immunosorbent assay.At 1 day before operation and 3, 5, and 7 days after operation, the early cognitive function was assessed using the Mini-Mental State Examination (MMSE), and the occurrence of postoperative cognitive dysfunction within 7 days after operation was recorded.The intraoperative consumption of propofol, remifentanil and sufentanil was recorded.The occurrence of complications related to ESP block was recorded.

Results:

Compared with group GA, the consumption of propofol, remifentanil, and sufentanil was significantly reduced, the serum S100β protein concentration and Mini-Mental State Examination score were decreased at 1 and 3 days after operation, serum NSE concentrations were decreased at 1, 3 and 5 days after operation, and the incidence of postoperative cognitive dysfunction was decreased in group ESP+ GA ( P<0.05). ESP block was successful, and no vascular and nerve damage was found in group ESP+ GA.

Conclusion:

ESP block combined with general anesthesia can improve the early cognitive function after thoracoscopic radical resection of lung cancer in elderly patients.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2021 Type: Article