Effects of Quadratus Lumborum Block on Inflammatory Factors,Pain Mediators and Brain Protection After Laparoscopic Hepatocellular Carcinoma Radical Surgery
Objective To explore and analyze the effects of quadratus lumborum block on inflammatory factors,pain mediators and brain protection after laparoscopic hepatocellular carcinoma radical surgery.Methods A total of 106 patients treated in Zhumadian Central Hospital from June 2021 to June 2022 who underwent laparoscopic radical hepatoma were selected and randomly divided into observation group and control group,with 53 cases in each group.The control group received surgical treatment under general anesthesia,and the observation group received surgical treatment under quadratus lumborum block combined with general anesthesia.Serum samples were collected before surgery and 24 h after surgery,and the levels of inflammatory factors and pain mediators were determined by enzyme-related immunosorbent assay.Radial artery blood and internal jugular vein bulbar blood were collected to measure the cerebral oxygen metabolism index.The cognitive function of patients was assessed by the mini-mental state examination(MMSE)before and after surgery.Results Before surgery,there were no differences in serum inflammatory factors such as interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),pain mediators such as substance(SP),neuropeptide(NPY),dopamine(DA),norepinephrine(NE)and brain oxygen metabolism indexes such as jugular bulb venous oxygen saturation(SjvO2),arterial-internal jugular vein bulb blood oxygen content difference(Da-jvO2),cerebral oxygen extraction rate(CEO2)between two groups(P＞0.05).After surgery,serum levels of IL-6,IL-10,TNF-α,SP,NPY,Da,NE,Da-jvO2 and CEO2 in two groups were higher than those before surgery,and the observation group were lower than those in control group(P＜0.05).SjvO2 was lower than that before surgery,but the observation group was higher than the control group(P＜0.05).Before surgery,there was no difference in MMSE scores between two groups(P＞0.05).Before surgery,there was no difference MMSE score between the two groups(P＞0.05).After surgery,MMSE score was decreased in both groups,while the postoperative observation group was higher than the control group(P＜0.05).Conclusion Laparoscopic radical resection of liver cancer by means of quadratus lumborum block can effectively reduce postoperative inflammatory factors and pain mediators,improve cerebral oxygen metabolism,and promote postoperative cognitive function recovery,which has a positive effect on brain protection.
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