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胸椎旁神经阻滞联合丙泊酚静脉全身麻醉对肺癌根治术患者VEGF和TGF-β的影响

Effect of thoracic paraspinal block-propofol intravenous general anesthesia on VEGF and TGF-β in patients receiving radical resection of lung cancer.

作者信息

Sen Yang, Xiyang Hu, Yu Han

机构信息

First Department of Anesthesia.

Department of Radiology.

出版信息

Medicine (Baltimore). 2019 Nov;98(47):e18088. doi: 10.1097/MD.0000000000018088.

Abstract

The objective of this study is to compare the effects of paravertebral nerve block-propofol intravenous general anesthesia (PPA) and sevoflurane inhalation general anesthesia (SGA) on the expression of serum vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-β) in patients undergoing radical resection of lung cancer.Patients undergoing radical resection of lung cancer were divided into PPA group and SGA group. In PPA group, thoracic paraspinal nerve block was performed with 0.5% ropivacaine (2 mg/kg) before general anesthesia. Anesthesia was maintained with 2.5-3.5 μg/mL TCI of propofol. In SGA group, anesthesia was maintained with 1.0-1.5 MAC sevoflurane. The dosage of opioids during and 24 h after operation, the pain score at 2, 8, 24, 48, and 72 h after operation, and the concentrations of serum VEGF and TGF-β before and 24 h after operation were observed in the two groups.The intraoperative dosage of remifentanil in PPA group was significantly less than that in SGA group (P < 0.05). The dosage of sufentanil in SGA group was significantly less than that in SGA group at 24 h after operation (P < 0.05). The VAS score at 2, 8, and 24 h after operation was significantly lower than that in SGA group (P < 0.05). The serum VEGF and TGF-β concentration in PPA group was significantly lower than that in SGA group (P < 0.05).Thoracic paravertebral nerve block-propofol intravenous general anesthesia can reduce the dosage of opioids, improve the effect of postoperative analgesia, and reduce the serum concentration of tumor angiogenesis-related factors in patients undergoing radical resection of lung cancer.

摘要

本研究的目的是比较椎旁神经阻滞-丙泊酚静脉全身麻醉(PPA)和七氟醚吸入全身麻醉(SGA)对肺癌根治术患者血清血管内皮生长因子(VEGF)和转化生长因子β(TGF-β)表达的影响。将接受肺癌根治术的患者分为PPA组和SGA组。PPA组在全身麻醉前用0.5%罗哌卡因(2mg/kg)进行胸段椎旁神经阻滞。用2.5-3.5μg/mL丙泊酚靶控输注维持麻醉。SGA组用1.0-1.5MAC七氟醚维持麻醉。观察两组患者术中及术后24小时阿片类药物用量、术后2、8、24、48和72小时疼痛评分以及术前和术后24小时血清VEGF和TGF-β浓度。PPA组术中瑞芬太尼用量明显少于SGA组(P<0.05)。SGA组术后24小时舒芬太尼用量明显少于PPA组(P<0.05)。术后2、8和24小时VAS评分明显低于SGA组(P<0.05)。PPA组血清VEGF和TGF-β浓度明显低于SGA组(P<0.05)。胸段椎旁神经阻滞-丙泊酚静脉全身麻醉可减少肺癌根治术患者阿片类药物用量,提高术后镇痛效果,并降低肿瘤血管生成相关因子的血清浓度。

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