Influence of Butorphanol Pretreatment Combined with Ultrasound-guided Thoracic Paravertebral Nerve Block Anesthesia on Analgesic Effect and Stress Response in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer
Objective:To explore the influence of butorphanol pretreatment combined with ultrasound-guided thoracic paraverte-bral nerve block anesthesia(TPVB)on analgesic effect and stress response in patients undergoing thoracoscopic radical resection of lung cancer.Methods:Sixty patients with lung cancer in our hospital were selected from May 2021 to June 2022 and were classified into ob-servation group(n=30)and control group(n=30)by random number table method.Both groups received intravenous anesthesia and were treated with patient-controlled intravenous analgesia(PCIA)after surgery,and the observation group performed ultrasound-guided TPVB before surgery and was given butorphanol pretreatment.The hemodynamics,anesthetic effect,postoperative pain status,stress response and occurrence of adverse reactions were compared between the two groups.Results:Compared with T0,the heart rate(HR)and mean arterial pressure(MAP)in the two groups were decreased at T,(P＜0.05).The HR and MAP were increased at T2 in the two groups com-pared with those at T1(P＜0.05).The HR and MAP at T2 and T3 in observation group were lower compared to control group(P＜0.05).The propofol dosage,remifentanil dosage,extubation time and PCIA use frequency in observation group were lower,shorter or less than those in control group(P＜0.05).At 8 h,12 h and 24 h after surgery,the pain degrees at rest and cough in observation group were milder than those in control group(P＜0.05).After surgery,the levels of epinephrine(E),cortisol(Cor)and adrenocorticotropic hormone(ACTH)were risen in the two groups(P＜0.05),but the observation group had lower levels(P＜0.05).There was no significant difference in the to-tal incidence rate of adverse reactions between the two groups(P＞0.05).Conclusion:Butorphanol pretreatment combined with ultra-sound-guided TPVB can control the hemodynamics and total dosage of opioids of patients undergoing thoracoscopic radical resection of lung cancer,shorten the extubation time,and relieve the postoperative pain and stress response.
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