Effects of continuous thoracic paravertebral block combined with general anesthesia on postoperative rehabilitation and immune function in lung cancer surgery

Objective To investigate the effect of continuous thoracic paravertebral block (CTPVB) combined with general anesthesia on postoperative rehabilitation and immune function in lung cancer surgery, in order to provide theoretical basis for its clinical promotion. Methods From February 2016 to February 2018, 102 cases with open chest resection of lung cancer were continuously collected, and divided into study group (CTPVB combined with general anesthesia, n=69) and control group (single general anesthesia, n=33) according to patients' wishes. Differences in postoperative serum pain medium, stress hormone, immune function were compared between at 1st hour, 3rd and 7th day after operation, and postoperative rehabilitation differences also compared. Results No statistical differences were found in general clinical data and surgical data between two groups (all P>0.05). However, serum pain medium neuropeptide Y, 5-hydroxytryptamine and prostate E2 in the study group were significantly lower than those in the control group (all P<0.05) in the first hour, 3rd day and 7th day after operation. These indicated that CTPVB combined with general anesthesia had significant analgesic effect.Also, serum stress hormone angiotensin, adrenocorticotropic hormone, cortisol were significantly lower and immune function indexes IgA, IgG and HLA-DR in were significantly higher the study group than those in the control group (all P<0.05) in the first hour and 3rd day after operation. These suggested that the combination of general anesthesia with CTPVB can effectively reduce the level of postoperative stress response and the degree of postoperative immune injury in patients with lung cancer.Forced expiratory volume in the 3rd day after extubation and oxygenation index in the 3rd and 7th day after extubation in the study group was significantly higher than that in the control group (P<0.05). These suggested that the combination of general anesthesia with CTPVB has less damage to respiratory function, which was in favour of postoperative rehabilitation. Conclusion CTPVB combined with general anesthesia has a significant analgesic effect in the surgery of patients with lung cancer, moreover, can effectively reduce postoperative stress response and immune injury degree, promoted the recovery of lung function, thus contributed to the postoperative rehabilitation and worthy of clinical promotion.