Effect of thoracic paravertebral block on inflammatory responses in patients undergoing thoracoscopic radical resection of lung cancer with general anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of thoracic paravertebral block (TPVB) on inflammatory responses in the patients undergoing thoracoscopic radical resection of lung cancer with general anesthesia.Methods Eighty patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n =40 each) using a random number table method:control group (group C) and TPVB group.Ultrasound-guided TPVB was performed with 0.5％ ropivacaine 10 ml which was injected into the paravertebral space of T4,7 at 30 min before anesthesia induction in group T.Patient-controlled intravenous analgesia (PCIA) was performed at the end of surgery.When visual analogue scale score＞3,morphine 5-10 mg was intravenously injected.Venous blood samples were collected immediately before surgery (T0) and at 12,24 and 48 h after surgery (T1-3) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The pressing times of PCIA and total volume of fluid infused were recorded at T2,3.The patients were followed up for 48 h after surgery,the development of nausea and vomiting,somnolence and pruritus was recorded,and the total occurrence of adverse reactions was calculated.Results Compared with group C,the pressing times of PCIA and total volume of fluid infused were significantly decreased at T2,3,the incidence of nausea and vomiting,total incidence of adverse reactions and the number of cases required morphine were decreased,and the serum concentration of IL-6 was decreased and the serum concentration of IL-10 was increased at T1-3 in group T (P＜0.05).Conclusion TPVB can alleviate inflammatory responses in the patients undergoing thoracoscopic radical resection of lung cancer with general anesthesia.