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右美托咪定联合胸椎旁神经阻滞应用于胃癌开腹手术的术后镇痛效果

Postoperative analgesic effect of dexmedetomidine combined with TPVB applied to open gastrectomy for gastric cancer.

作者信息

Wan Weilan, Hou Zhiqi, Qiu Qiuying

机构信息

Department of Anesthesiology, Huizhou Municipal Central Hospital, Huizhou City, China.

出版信息

Immunopharmacol Immunotoxicol. 2023 Apr;45(2):234-239. doi: 10.1080/08923973.2022.2136573. Epub 2022 Oct 24.

Abstract

OBJECTIVES

This study is aimed to investigate the analgesic effect of combined dexmedetomidine and thoracic paravertebral nerve block (TPVB) on gastric cancer (GC) patients undergoing open gastrectomy.

METHODS

From May 2019 to Nov 2020, a total of 80 GC patients preparing for open gastrectomy were enrolled in our hospital and were divided into the ropivacaine (RO) group and the ropivacaine + dexmedetomidine (RD) group . All of the patients underwent TPVB. The characteristics, usage of patient-controlled analgesia (PCA), adverse events, visual analogue scale (VAS) scores, inflammatory cytokines, and T cell subgroups between the two groups were compared.

RESULTS

Patients in the RD group showed the decreased occurrence rate of postoperative adverse events and VAS scores and improved anti-inflammation and immune function. These findings implied that the application of dexmedetomidine in combination with RO in TPVB has a good postoperative analgesic effect, as well as anti-inflammatory and immune-enhancing effects.

CONCLUSIONS

Dexmedetomidine as an adjunct analgesic may be potentially applied in clinical practice for GC patients undergoing open gastrectomy.

摘要

目的

本研究旨在探讨右美托咪定联合胸椎旁神经阻滞(TPVB)对接受开腹胃癌根治术的胃癌(GC)患者的镇痛效果。

方法

2019年5月至2020年11月,我院共纳入80例准备接受开腹胃癌根治术的GC患者,分为罗哌卡因(RO)组和罗哌卡因+右美托咪定(RD)组。所有患者均接受TPVB。比较两组患者的特征、自控镇痛(PCA)使用情况、不良事件、视觉模拟评分(VAS)、炎症细胞因子及T细胞亚群。

结果

RD组患者术后不良事件发生率及VAS评分降低,抗炎及免疫功能改善。这些结果表明,右美托咪定与RO联合应用于TPVB具有良好的术后镇痛效果,以及抗炎和免疫增强作用。

结论

右美托咪定作为辅助镇痛药可能在接受开腹胃癌根治术的GC患者的临床实践中具有潜在应用价值。

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