Volume 22 Issue 8
Aug.  2024
Turn off MathJax
Article Contents
WANG Xiaoyan, PAN Qin, HUANG Changjun, LI Yuhong. Effect of preoperative erector spinae plane block on postoperative stress and opioid demand of patients undergoing thoracic surgery[J]. Chinese Journal of General Practice, 2024, 22(8): 1350-1353. doi: 10.16766/j.cnki.issn.1674-4152.003634
Citation: WANG Xiaoyan, PAN Qin, HUANG Changjun, LI Yuhong. Effect of preoperative erector spinae plane block on postoperative stress and opioid demand of patients undergoing thoracic surgery[J]. Chinese Journal of General Practice, 2024, 22(8): 1350-1353. doi: 10.16766/j.cnki.issn.1674-4152.003634

Effect of preoperative erector spinae plane block on postoperative stress and opioid demand of patients undergoing thoracic surgery

doi: 10.16766/j.cnki.issn.1674-4152.003634
Funds:

 2024KY270

  • Received Date: 2024-03-11
    Available Online: 2024-11-19
  •   Objective  High-dose opioid analgesics can control severe pain after thoracic surgery, but can easily cause nausea, respiratory depression, and other side effects. In this study, erector spinae plane block (ESPB) was applied to thoracic surgery before operation to explore its influence on postoperative stress and opioid demand of patients.  Methods  From March 2021 to March 2023, 200 patients with lung cancer who underwent elective radical resection of lung cancer in the First People ' s Hospital of Linping District, Hangzhou were divided into a control group (pure intravenous anesthesia) and a compound group (ESPB combined intravenous general anesthesia) according to anesthesia methods, with 100 patients in each group. The indexes of oxidative stress, serum-related indexes, pain, and opioid use were compared between the two groups.  Results  Malondialdehyde (MDA) levels increased and super oxide dismutase (SOD) levels decreased 24 h after operation in lung cancer patients in both groups. Moreover, MDA and SOD levels in the compound group [(6.69±1.84) nmol/L, (37.30±6.42) U/mL] were lower than those in the control group [(9.03±1.35) nmol/L, (41.56±6.88) U/mL, P < 0.05]. At T1, T2, and T3, the levels of IL-6, Cor, and Ang-Ⅱ in the compound group were lower than those in the control group, and the levels of IL-10 were higher than those in the control group (P < 0.05). At T2, T3, and T4, the scores of resting and dynamic VAS in the compound group were lower than those in the control group (P < 0.05). The dosage of remifentanil in the compound group was (554.8±97.2) μg. The total amount of sufentanil infusion [(28.7±5.9) mL] and the number of supplementary infusion [(2.1±0.6) times] in 24 h were lower than those in the control group [(675.2±164.5) μg, (39.5±6.2) mL, (3.2±0.9) times, P < 0.05].  Conclusion  The application of ESPB combined with intravenous general anesthesia in radical resection of lung cancer can improve stress and inflammatory reaction, and reduce postoperative pain and the demand for opioids. It is a feasible and superior anesthesia method.

     

  • loading
  • [1]
    肖凡, 罗振中, 周斌, 等. 右美托咪定复合胸椎旁神经阻滞对开胸术后疼痛及认知功能的影响[J]. 南昌大学学报(医学版), 2018, 58(1): 60-64.

    XIAO F, LUO Z Z, ZHOU B, et al. Effect of dexmedetomidine combined with thoracic paravertebral block on pain and cognitive function after thoracotomy[J]. Journal of Nanchang University: Medical Sciences, 2018, 58(1): 60-64.
    [2]
    贡会源, 杏福宝, 李晨, 等. 单孔胸腔镜下Ⅰ期非小细胞肺癌根治术中模块化系统性淋巴结清扫的应用研究[J]. 中华全科医学, 2023, 21(9): 1482-1486. doi: 10.16766/j.cnki.issn.1674-4152.003151

    GONG H Y, XING F B, LI C, et al. Application of modular systematic lymph node dissection in uniportal thoracoscopic radical resection for stage Ⅰ non-small cell lung cance[J]. Chinese Journal of General Practice, 2023, 21(9): 1482-1486. doi: 10.16766/j.cnki.issn.1674-4152.003151
    [3]
    JAYA A, TANTRI A R, HERIWARDITO A, et al. Single-centre, double-blind, randomised, parallel-group, superiority study to evaluate the effectiveness of general anaesthesia and ultrasound-guided transversus thoracis muscle plane block combination in adult cardiac surgery for reducing the surgical stress response: clinical trial protocol[J]. BMJ Open, 2021, 11(11): e051008. DOI: 10.1136/bmjopen-2021-051008.
    [4]
    LUIS-NAVARRO J C, SEDA-GUZMÁN M, LUIS-MORENO C, et al. The erector spinae plane block in 4 cases of video-assisted thoracic surgery[J]. Rev Esp Anestesiol Reanim (Engl Ed), 2018, 65(4): 204-208. doi: 10.1016/j.redar.2017.12.004
    [5]
    李群, 叶茂亭, 冉紫蕴, 等. 胸腔镜下肺癌根治术患者术后心脏并发症的影响因素分析[J]. 中国医学前沿杂志(电子版), 2021, 13(6): 53-57.

    LI Q, YE M T, RAN Z Y, et al. Analysis of the influencing factors of postoperative cardiac complications in lung cancer patients underwent thoracoscopic radical resection[J]. Chinese Journal of the Frontiers of Medical Science(Electronic Version), 2021, 13(6): 53-57.
    [6]
    国家卫生健康委办公厅. 原发性肺癌诊疗指南(2022年版)[J]. 协和医学杂志, 2022, 13(4): 549-570.

    General Office of National Health Commission of the People ' s Republic of China. Clinical practice guideline for primary lung cancer (2022 version)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(4): 549-570.
    [7]
    SHAFSHAK T S, ELNEMR R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain[J]. J Clin Rheumatol, 2021, 27(7): 282-285. doi: 10.1097/RHU.0000000000001320
    [8]
    王宁, 方园林, 路立军. 调整引流管进管方向与长度对改善胸腔闭式引流患者疼痛的临床研究[J]. 现代医药卫生, 2021, 37(13): 2272-2274. doi: 10.3969/j.issn.1009-5519.2021.13.031

    WANG N, FANG Y L, LU L J. Clinical study on the improvement of pain in patients with closed thoracic drainage by adjusting the direction and length of drainage tube[J]. Journal of Modern Medicine & Health, 2021, 37(13): 2272-2274. doi: 10.3969/j.issn.1009-5519.2021.13.031
    [9]
    BOS E M E, HAUMANN J, DE QUELERIJ M, et al. Haematoma and abscess after neuraxial anaesthesia: a review of 647 cases[J]. Br J Anaesth, 2018, 120(4): 693-704. doi: 10.1016/j.bja.2017.11.105
    [10]
    HERNANDEZ M A, PALAZZI L, LAPALMA J, et al. Erector spinae plane block for inguinal hernia repair in preterm infants[J]. Paediatr Anaesth, 2018, 28(3): 298-299. doi: 10.1111/pan.13325
    [11]
    TANTRI A R, RAHMI R, MARSABAN A, et al. Comparison of postoperative IL-6 and IL-10 levels following Erector Spinae Plane Block(ESPB) and classical Thoracolumbar Interfascial Plane (TLIP) block in a posterior lumbar decompression and stabilization procedure: a randomized controlled trial[J]. BMC Anesthesiol, 2023, 23(1): 13. doi: 10.1186/s12871-023-01973-w
    [12]
    HSING C H, WANG J J. Clinical implication of perioperative inflammatory cytokine alteration[J]. Acta Anaesthesiol Taiwan, 2015, 53(1): 23-28. doi: 10.1016/j.aat.2015.03.002
    [13]
    VEIGA M, COSTA D, BRAZÀO I. Erector spinae plane block for radical mastectomy: a new indication?[J]. Rev Esp Anestesiol Reanim (Engl Ed), 2018, 65(2): 112-115. doi: 10.1016/j.redar.2017.08.004
    [14]
    YAMAK ALTINPULLUK E, GARCÍA SIMÝN D, FAJARDO-PÉREZ M. Erector spinae plane block for analgesia after lower segment caesarean section: case report[J]. Rev Esp Anestesiol Reanim (Engl Ed), 2018, 65(5): 284-286. doi: 10.1016/j.redar.2017.11.006
    [15]
    RAFT J, RICHEBÉ P. Anesthesia for thoracic ambulatory surgery[J]. Curr Opin Anaesthesiol, 2019, 32(6): 735-742. doi: 10.1097/ACO.0000000000000795
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Article Metrics

    Article views (1) PDF downloads(0) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return