Zhen Wu, Hong-Qin Cai, Chun-Feng Wang, Xiang-Yuan Yu, Jie-Qiong Wang
{"title":"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。","authors":"Zhen Wu, Hong-Qin Cai, Chun-Feng Wang, Xiang-Yuan Yu, Jie-Qiong Wang","doi":"10.4240/wjgs.v16.i9.2961","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group (<i>P</i> < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery (<i>P</i> > 0.05). The number of CD3<sup>+</sup>, CD4<sup>+</sup>, and CD4<sup>+</sup>/CD8<sup>+</sup> cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8<sup>+</sup> cells was lower in the observation group than in the control group (<i>P</i> < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 9","pages":"2961-2967"},"PeriodicalIF":1.8000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438819/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia.\",\"authors\":\"Zhen Wu, Hong-Qin Cai, Chun-Feng Wang, Xiang-Yuan Yu, Jie-Qiong Wang\",\"doi\":\"10.4240/wjgs.v16.i9.2961\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group (<i>P</i> < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery (<i>P</i> > 0.05). The number of CD3<sup>+</sup>, CD4<sup>+</sup>, and CD4<sup>+</sup>/CD8<sup>+</sup> cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8<sup>+</sup> cells was lower in the observation group than in the control group (<i>P</i> < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23759,\"journal\":{\"name\":\"World Journal of Gastrointestinal Surgery\",\"volume\":\"16 9\",\"pages\":\"2961-2967\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438819/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4240/wjgs.v16.i9.2961\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v16.i9.2961","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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.