Effects of different nerve block anesthesia protocols on postoperative pain,cognitive function and serum Aβ-42,IL-6 and tau-181 protein in patients with radical gastrectomy for gastric cancer
Objective To investigate the effects of different nerve block anesthesia schemes[para-vertebral nerve block(TPVB)and stellate ganglion block(SGB)]on postoperative pain,cognitive function, and serum β-amyloid protein-42(Aβ-42),interleukin-6(IL-6)and tau-181 protein in patients undergoing rad-ical gastrectomy. Methods A total of 120 patients undergoing elective laparoscopic radical gastrectomy for gastric cancer at the First Affiliated Hospital of Hebei North University from January 2020 to January 2023 were selected as the research subjects. Using the random number table method ,they were divided into two groups:the TPVB group and the SGB group,with 60 cases in each group. Both groups received the same gen-eral anesthesia method. The TPVB group received a paravertebral nerve block before anesthesia induction , while the SGB group received a progressive stellate ganglion block before anesthesia induction. Pain and cogni-tive function were assessed using the Visual Analogue Scale(VAS)and the Montreal Cognitive Assessment Scale(MoCA). The changes in pain at different time points after the operation were monitored in both groups. The changes in cognitive function and levels of serum Aβ-42,IL-6 and tau-181 protein before the operation,1 day and 3 days after the operation were compared between the two groups. Results There was no significant difference in VAS scores between the two groups at 1,6,12,and 24 hours after the operation(t=1.183, 1.325,0.397,0.611,P>0.05). The scores of the MoCA scale in the TPVB group were lower than those in the SGB group at 1 and 3 days after the operation,and the differences were statistically significant (t=2.281, 3.218,P<0.05). The levels of Aβ-42,IL-6 and tau-181 protein in the TPVB group were higher than those in the SGB group at 1 and 3 days after the operation,and the differences were statistically significant(t=2.065, 2.122,2.558,2.167,2.515,2.596,P<0.05). Conclusion Both TPVB and SGB nerve block anesthesia tech-niques have positive effects on postoperative analgesia in patients undergoing radical gastrectomy. However , SGB has more advantages than TPVB in reducing inflammatory response and improving cognitive function.
Different nerve block anesthesia protocolsLaparoscopic radical gastrectomy for gastric cancerCognitive functionβ-amyloid protein-42Interleukin-6Tau-181 protein
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