星状神经节阻滞全静脉麻醉后胃癌手术患者的疼痛和免疫功能。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastrointestinal Surgery Pub Date : 2024-09-27 DOI:10.4240/wjgs.v16.i9.2961
Zhen Wu, Hong-Qin Cai, Chun-Feng Wang, Xiang-Yuan Yu, Jie-Qiong Wang
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引用次数: 0

摘要

背景:星状神经节阻滞是一种常用的交感神经阻滞技术:目的:分析星状神经节阻滞联合全文凭静脉麻醉对腹腔镜胃癌根治术患者术后疼痛及免疫功能的影响,为胃癌根治术麻醉方案的制定提供参考依据:本研究纳入了2022年1月至2024年3月期间接受腹腔镜胃癌根治术的112例患者。性别不限。患者分组方法采用数字随机表法,每组病例数为56例。对照组采用全静脉麻醉,观察组按照全静脉麻醉方案复合星状神经节阻滞。比较两组的术后血流动力学、疼痛程度和免疫指数:结果:插管后,观察组的心率和平均动脉压均低于对照组(P < 0.05)。两组在术后 2 小时、12 小时、24 小时和 48 小时的疼痛程度比较(P > 0.05)。手术结束时,观察组的 CD3+、CD4+ 和 CD4+/CD8+ 细胞数量高于对照组,而观察组的 CD8+ 细胞数量低于对照组(P < 0.05)。两组在异丙酚用量、苏醒时间、拔管时间和术后不良反应方面无明显差异(P > 0.05):结论:应用星状神经节阻滞联合全静脉麻醉对腹腔镜根治性胃癌手术患者的术后疼痛水平无明显影响。结论:应用星状神经节阻滞联合全静脉麻醉对腹腔镜根治性胃癌手术患者的术后疼痛水平无明显影响,但可安全减轻手术对患者免疫功能的影响,值得临床应用。
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Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia.

Background: Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.

Aim: To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer (GC) surgery to provide a reference basis for the formulation of anesthesia protocols for radical GC surgery.

Methods: This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024. There was no restriction on sex. The patient grouping method used was a digital random table method, and the number of cases in each group was 56. The control group was administered total intravenous anesthesia, and the observation group compounded the stellate ganglion block according to the total intravenous anesthesia protocol. Postoperative hemodynamics, pain levels, and immune indices were compared between the groups.

Results: The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group (P < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery (P > 0.05). The number of CD3+, CD4+, and CD4+/CD8+ cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8+ cells was lower in the observation group than in the control group (P < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions (P > 0.05).

Conclusion: The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery. However, it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.

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