Observational Study
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World J Clin Cases. Mar 6, 2022; 10(7): 2174-2183
Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2174
Ultrasound-guided paravertebral nerve block anesthesia on the stress response and hemodynamics among lung cancer patients
Shu-Qing Zhen, Ming Jin, Yong-Xue Chen, Jian-Hua Li, Hua Wang, Hui-Xia Chen
Shu-Qing Zhen, Yong-Xue Chen, Jian-Hua Li, Hua Wang, Hui-Xia Chen, Department of Anesthesiology, Handan Central Hospital, Handan 056001, Hebei Province, China
Ming Jin, Department of Anesthesiology, Affiliated Hospital of Hebei University of Engineering, Handan 056002, Hebei Province, China
Author contributions: Zhen SQ and Chen HX designed this retrospective study, Zhen SQ, Jin M, Chen YX and Li JH wrote this paper; Zhen SQ, Jin M, Chen YX, Li JH, and Wang H were responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Handan Central Hospital Institutional Review Board (Approval No.2020BL-008-12).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Xia Chen, BMed, Attending Doctor, Department of Anesthesiology, Handan Central Hospital, No. 15 Zhonghua Nan Road, Handan 056001, Hebei Province, China. hdzxyychx@126.com
Received: November 21, 2021
Peer-review started: November 21, 2021
First decision: December 9, 2021
Revised: December 26, 2021
Accepted: January 22, 2022
Article in press: January 22, 2022
Published online: March 6, 2022
Processing time: 100 Days and 16.2 Hours
ARTICLE HIGHLIGHTS
Research background

Thoracic surgery for radical resection of lung tumor requires deep anesthesia which can lead to an adverse inflammatory response, loss of hemodynamic stability, and decreased immune function.

Research motivation

We evaluated the feasibility and benefits of ultrasound-guided paravertebral nerve block anesthesia in combination with general anesthesia for thoracic surgery for lung cancer.

Research objectives

This study aimed to evaluate the application of ultrasound-guided paravertebral nerve block anesthesia for lung cancer surgery to inform practice.

Research methods

Patients in the control group received an epidural block combined with general anesthesia. For patients in the observation group, ultrasound-guided paravertebral nerve block anesthesia was used before induction of general anesthesia. The concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay, with the concentrations of epinephrine, norepinephrine, and dopamine determined by radio-immunity turbidimetry. The mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) were measured at baseline, before surgery and anesthesia, 15 min after anesthesia (T1), induction intubation, 5 min after skin incision and before extubation (T4) in both groups. The stress response and hemodynamic data were reported as a mean ± SD.

Research results

The use of intra-operative remifentanil and propofol and of postoperative sufentanil was significantly less in the observation than the control group. The MAP and HR at T1 through T4 were higher for the observation than control group. The postoperative levels of epinephrine, norepinephrine and dopamine were higher after surgery than at baseline for both groups. However, these levels were lower in the observation than control group at T1 through T4. The postoperative TNF-α and IL-6 levels after surgery were lower in the observation than in the control group. This difference in incidence rate of adverse reactions was not different.

Research conclusions

Ultrasound-guided paravertebral nerve block anesthesia has good indication for lung cancer surgery, with little effect on patients’ stress and hemodynamic responses.

Research perspectives

Large sample studies need to performed in the future.