Application of TPVB in patients undergoing lung cancer surgery and the influence on stress and immune function
Objective To analyze the application of thoracic paravertebral block(TPVB)in patients undergoing lung cancer surgery,and the influence on stress and immune function.Methods A total of 200 patients who underwent lung cancer surgery in the Second People's Hospital of Yibin Hospital from March 2022 to May 2023 were selected as the research subjects.They were divided into the study group(TPVB)and the control group(intercostal nerve block)by random number table method,with 100 patients in each group.The recovery status of the two groups was recorded,and their pain visual analogue scale(VAS)scores were compared.Mean arterial pressure(MAP),heart rate(HR)and cortisol(Cor)concentrations in the two groups before surgery(T0),after 15 min of medication(T1),after induction and intubation(T2),at skin incision(T3)and before extubation(T4)were analyzed.Immune function indicators,montreal cognitive assessment(MoCA)scores,and the incidence of adverse reactions were compared between the two groups.Results The recovery time of spontaneous respiration,first exhaust time,first ambulatory time,and the dosage of propofol in the study group were shorter/lower than those in the control group(P＜0.05).Surgical time and anesthesia duration of the two groups had no significant difference(P＞0.05).The VAS scores of the study group at 12 h,24 h,and 48 h after surgery were lower than those of the control group(P＜0.05).MAP,HR,and Cor of the study group from Tl to T4 were lower than those of the control group(P＜0.05).The level of CD8+in the study group at 48 h after surgery was lower than those in the control group.CD4+and CD4+/CD8+were higher than those in the control group(P＜0.05).The MoCA scores of the study group at 24 h and 48 h after surgery were higher than those of the control group,and the incidence of cognitive impairment at 48 h after surgery was lower than that in the control group(P＜0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P＜0.05).Conclusion The application of TPVB in patients undergoing lung cancer surgery can promote postoperative recovery,achieve satisfactory analgesic effects,and reduce the influence on stress and immune function,with low risks of cognitive impairment and adverse reactions after surgery.
Thoracic paravertebral blockLung cancer surgerySystemic stressImmune functionCogni-tive impairment
万方数据
维普
